title: Prospective cohort study protocol to describe the transfer of patients from intensive care units to hospital wards.
abstract: BACKGROUND
  The transfer of patient care between the intensive care unit (ICU) and the hospital ward is associated with increased risk of medical error and adverse events. This study will describe patient transfer from ICU to hospital ward by documenting (1) patient, family and provider experiences related to ICU transfer, (2) communication between stakeholders involved in ICU transfer, (3) adverse events that follow ICU transfer and (4) opportunities to improve ICU to hospital ward transfer.
  
  
  METHODS
  This is a mixed methods prospective observational study of ICU to hospital ward transfer practices in 10 ICUs across Canada. We will recruit 50 patients at each site (n=500) who are transferred from ICU to hospital ward, and distribute surveys to enrolled patients, family members, and healthcare providers (ICU and ward physicians and nurses) after patient transfer. A random sample of 6 consenting study participants (patients, family members, healthcare providers) from each study site (n=60) will be offered an opportunity to participate in interviews to further describe stakeholders' experience with ICU to hospital ward transfer. We will abstract information from patient health records to identify clinical data and use of transfer tools, and identify adverse events that are related to the transfer.
  
  
  BACKGROUND
  Research ethics board approval has been obtained at the coordinating study centre (UofC REB13-0021) and 5 study sites (UofA Pro00050646; UBC-PHC H14-01667; Sunnybrook 336-2014; QCH 14-07; Sherbrooke 14-172). Dissemination of the findings will provide a comprehensive description of transfer from ICU to hospital ward in Canada including the uptake of validated or local transfer tools, a conceptual framework of the experiences and needs of stakeholders in the ICU transfer process, a summary of adverse events experienced by patients after transfer from ICU to hospital ward, and opportunities to guide quality improvement efforts.
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Denise L
authors.initials: DL
authors.lastname: Buchner
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bagshaw
authors.affiliation: Division of Critical Care Medicine and Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Dodek
authors.affiliation: The Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Forster
authors.affiliation: Department of Medicine, Department of Critical Care Medicine, Sunnybrook Hospital, University of Toronto, Toronto, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fowler
authors.affiliation: Centre de Recherche du CHU de Sherbrooke, Universite de Sherbrooke, Sherbrooke, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Lamontagne
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, CHU de Quebec Research Center, Quebec City, Canada.
authors.forename: Alexis F
authors.initials: AF
authors.lastname: Turgeon
authors.affiliation: Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Potestio
authors.affiliation: Department of Critical Care Medicine, University of Calgary, Calgary, Canada.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
mesh_terms: D002170:Canada; D002985:Clinical Protocols; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards; D003625:Data Collection; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007400:Interprofessional Relations / Q000941:ethics; D008499:Medical Records; D061214:Patient Safety; D010360:Patient Transfer / Q000379:methods* / Q000592:standards; D011369:Professional-Patient Relations; D011446:Prospective Studies; D058996:Quality Improvement