A quality improvement project to decrease emergency department and medical intensive care unit transfer times.

Objective: To reduce transfer time of critically ill patients from the emergency department (ED) to the medical intensive care unit (MICU).

Design: A prospective, observational study assessing preimplementation and postimplementation of quality improvement interventions in a tertiary academic medical center.

Interventions: A team of frontline health care professional including ED, MICU, and supporting services using the clinical microsystems approach mapped out existing practice patterns, determined causes for delays, and used the Plan-Do-Study-Act to test changes.

Critical care nurses' perception of time spent at rapid responses.

Rationale: Critical care nurses are an integral part of rapid response (RR) teams. The length of time they spend away from an intensive care unit (ICU) to attend RRs and how ICU nurses perceive the time away from the ICU has not been previously evaluated.

Objectives: To determine: (1) the time an ICU nurse spends at RRs; (2) ICU nurses' view of nursing absence; and (3) RR characteristics associated with longer nursing time.