Utilizing a transfer of care bundle to reduce unplanned readmissions to the cardiac intensive care unit

Introduction

Hospital-based intensive care is known to be a significant driver of healthcare costs. In the USA, intensive care unit (ICU) care accounted for 13% of all hospital costs in 2005.1 One aspect of ICU care that has been found to be both a driver of cost and a measure of quality is ICU readmissions.1 As a result, readmission to the ICU within a single hospitalisation is now viewed by payers as a potential preventable complication, and payers are beginning to propose denial of charges associated with these episodes of care given the impact on length of stay (LOS) and hospital charges.2 Examples from the literature include data from an adult medicine multicentre database enquiry that demonstrated that patients who were readmitted to an ICU have a 2.5-fold increase in hospital LOS compared with patients who were not readmitted.3 Furthermore, Magruder et al

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