The Handover from Intensive Care Unit to General Ward: Baseline Performance and Participatory Design of an Electronic Follow-Up Plan.

The transfer of patients from intensive care unit (ICU) to general ward involves risk to patient health. To mitigate this risk the present study investigates the current use of follow-up plans in the handover from ICU to general ward and proposes a novel design of follow-up plans. On the basis of a record audit we find that follow-up plans exist for only 16% of the audited transfers, that these plans are rarely used, and that 25% of the patients with a plan die within 24 hours of their transfer. In a subsequent series of participatory-design workshops with ICU and ward nurses we devised an electronic follow-up plan that consists of an attend-to list rather than a checklist. The attend-to list specifies the issues of concern but leaves the process of attaining them for the general-ward nurses to decide, thereby acknowledging and utilizing their expertise.