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Journal article
Handoffs and transitions in critical care-understanding scalability: study protocol for a multicenter stepped wedge type 2 hybrid effectiveness-implementation trial
Implementation science : IS, v 16(1), pp 1-63
15 Jun 2021
PMID: 34130725
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background The implementation of evidence-based practices in critical care faces specific challenges, including intense time pressure and patient acuity. These challenges result in evidence-to-practice gaps that diminish the impact of proven-effective interventions for patients requiring intensive care unit support. Research is needed to understand and address implementation determinants in critical care settings.
Methods The Handoffs and Transitions in Critical Care-Understanding Scalability (HATRICC-US) study is a Type 2 hybrid effectiveness-implementation trial of standardized operating room (OR) to intensive care unit (ICU) handoffs. This mixed methods study will use a stepped wedge design with randomized roll out to test the effectiveness of a customized protocol for structuring communication between clinicians in the OR and the ICU. The study will be conducted in twelve ICUs (10 adult, 2 pediatric) based in five United States academic health systems. Contextual inquiry incorporating implementation science, systems engineering, and human factors engineering approaches will guide both protocol customization and identification of protocol implementation determinants. Implementation mapping will be used to select appropriate implementation strategies for each setting. Human-centered design will be used to create a digital toolkit for dissemination of study findings. The primary implementation outcome will be fidelity to the customized handoff protocol (unit of analysis: handoff). The primary effectiveness outcome will be a composite measure of new-onset organ failure cases (unit of analysis: ICU).
Discussion The HATRICC-US study will customize, implement, and evaluate standardized procedures for OR to ICU handoffs in a heterogenous group of United States academic medical center intensive care units. Findings from this study have the potential to improve postsurgical communication, decrease adverse clinical outcomes, and inform the implementation of other evidence-based practices in critical care settings.
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Details
- Title
- Handoffs and transitions in critical care-understanding scalability: study protocol for a multicenter stepped wedge type 2 hybrid effectiveness-implementation trial
- Creators
- Meghan B. Lane-Fall - Philadelphia UniversityAthena Christakos - , 3400 Spruce Street 6th Floor Dulles Building, Philadelphia, PA, 19104, USA.Gina C. Russell - Heritage Center of the Union League of PhiladelphiaBat-Zion Hose - , 423 Guardian Drive, 333 Blockley Hall, Philadelphia, PA, 19104, USA.Elizabeth D. Dauer - , 2450 W Hunting Park Ave, 3rd floor, Philadelphia, PA, 19129, USA.Philip E. Greilich - , 5323 Harry Hines Blvd, Dallas, TX, 75930, USA.Bommy Hong Mershon - , 1800 Orleans St, Suite 6364, Baltimore, MD, 21287, USA.Christopher P. Potestio - Cooper University HospitalErin W. Pukenas - , 401 S. Broadway, Camden, NJ, 08103, USA.John R. Kimberly - , 3620 Locust Walk, 2109 Steinberg-Dietrich Hall, Philadelphia, PA, 19104, USA.Alisa J. Stephens-Shields - , 423 Guardian Drive, 628 Blockley Hall, Philadelphia, PA, 19104, USA.Rebecca L. Trotta - , 3400 Spruce St., Philadelphia, PA, 19104, USA.Rinad S. Beidas - Philadelphia UniversityEllen J. Bass - Drexel University
- Publication Details
- Implementation science : IS, v 16(1), pp 1-63
- Publisher
- Springer Nature
- Number of pages
- 13
- Grant note
- 1R01HL153735-01 / National Heart, Lung, and Blood Institute of the United States National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:000661888000001
- Scopus ID
- 2-s2.0-85108103236
- Other Identifier
- 991019168133604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services