Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Editorials
1668 www.ccmjournal.org November 2022 • Volume 50 • Number 11
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KEY WORDS: care transitions; critical care; discharge planning; handoff
communication; patient transfer
E
fective physician-to-physician communication is essential for patient
safety, particularly at junctions when patient care transitions between
physician teams during hospitalization, such as from intensivists to hos-
pitalists in the early ICU afercare period. Tese transitions in care from the
ICU to intermediate care areas or wards, represent unique vulnerabilities for
patients, ofen attributed to residual organ damage, complex pharmacologic
therapies, and are prone to ICU-acquired defcits (e.g., delirium) (1). Although
the Situation-Background-Assessment-Recommendation communication
checklist is a familiar verbal and written communication strategy adopted for
structured updates in nursing (2, 3), the tradition-based practices of unstruc-
tured physician progress notes are receiving more scrutiny in composition and
timeliness. Electronic discharge (eDischarge) tools are increasingly embedded
within electronic health records (EHRs) to leverage existing patient-specifc
data entries (i.e., laboratory values, vascular access catheters) and thus poten-
tially ofer more complete, accurate, and efcient multidisciplinary documen-
tation relevant to handof communication (1).
In this issue of Critical Care Medicine, Stelfox et al (4) investigate the crucially
important step of timely and efective physician-to-physician ICU discharge
handof documentation to communicate clinical priorities for patients entering
the early ICU afercare period. Teir intervention of an EHR-enabled structured
ICU discharge note replaced a free-form dictation approach in four participat-
ing hospitals in Calgary, AB, Canada. Te primary outcome measures were
Valerie Danesh, PhD, RN, FCCM
1,2
Jonathan D. Hecht, MSN, APRN,
CCRN
2
Farzan Sasangohar, PhD
3,4
Communication Strategies and Patient Care
Transitions in the Early ICU Aftercare Period*
DOI: 10.1097/CCM.0000000000005666
*See also p. 1566.
Copyright © 2022 by the Society of
Critical Care Medicine and Wolters
Kluwer Health, Inc. All Rights
Reserved.