Discharge from ICU to the general ward within 4 hours of the decision to step down is a standard in both the ICS GPICS & SICSAG report. Implications to the Unit such as impaired ability to admit & increased cost of care are well recognised, yet little is known about the patient related outcomes. This project reviewed the impact of delayed discharge from the Aberdeen General ICU on patient related outcomes such as survival, readmissions & HAI rate. The local SICSAG dataset was reviewed for all discharges between 1st Jan 2016 & 27 Aug 2017. Records were then reviewed to identify the above outcomes.
A total of 831 patients were reviewed, who were well matched for APACHE II score & predicted mortality. The most common reasons for delayed discharge included lack of HDU bed (37%) & lack of ward bed (44%).
Delayed patients had:
*4.3 day increase in ICU to Hospital discharge time
*0.72% increase in HAIs, all pneumonias
Readmission rate was not increased for patients with delayed discharge (5.1% not delayed; 4.35% delayed). There was no impact on 6 or 12 months mortality between delayed and not delayed. Increased hospital LOS may be associated with a delay in receiving specialty specific rehab. Further studies should look at the role of visiting AHP support from the parent specialty. This study does not look at other important patient outcomes such as delirium, distress and patient feedback, which should be considered in future work