The aim of this study was to explore problems for patients and staff with the transfer process from AICU, to act on these problems and to implement solutions as identified by patients and staff. The project used Experience-Based Co-Design (EBCD) to provide an opportunity for staff and patients to work together.
Twenty-seven staff and seven patients were interviewed. Staff and patients identified main themes to take forward to a joint patient-staff event. Themes included: communication and information for patients and relatives; person-centred care and timing. Following the joint patient-staff event, action planning groups (with patients and staff) worked to implement solutions to improve the communication of doctors and nurses with patients and relatives.
The outcomes of the project were positive changes in the delivery of care to patients and their relatives, as highlighted by the evaluation of staff and patients’ experiences of the transfer process. Findings have been fed back to staff and the importance of good communication is continually highlighted. Changes in the way information is communicated have meant that information about the transfer process is clearer for patients and that relatives are more involved in the process. Staff have also gained confidence in capturing patients’ experiences and an annual patient-staff event to evaluate the sustainability of improvements is planned.
Key issues identified through the interviews and events were the importance of keeping patients informed, information giving, the use of patient centred language, checking if patients understand, allowing time to answer patient questions, and involving relatives in information giving.
The changes / improvements agreed as part of the project included:
- Patients’ views and experiences will be discussed during daily morning briefing meetings on AICU
- An intensive care booklet is now available on AICU for relatives and patients to read and keep http://icusteps.org/professionals/booklet
- Doctors will keep medical terminologies to simple and layman terms
- Adequate time will be given to patients and relatives so that they fully understand what has been said, explain the course of action and expectation. Doctors will confirm that information has been understood before leaving the patient’s bedside, or give the option to ask questions later
- The creation of a Respiratory HDU that will be handed to patients/relatives prior to transfer to the HDU to give them adequate information prior to transfer and to alleviate anxieties
The full study can be read here.