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Editorials |

The Complexities of ICU DischargeComplexities of ICU Discharge

May Hua, MD; Hannah Wunsch, MD
Author and Funding Information

From the Department of Anesthesiology (Drs Hua and Wunsch), Columbia University; the Department of Critical Care Medicine (Dr Wunsch), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and Department of Anesthesia (Dr Wunsch), University of Toronto, Toronto, ON, Canada.

CORRESPONDENCE TO: Hannah Wunsch, MD, Department of Critical Care Medicine, Sunnybrook Hospital, 2075 Bayview Ave, Rm D1.08, Toronto, ON, M4N 3M5, Canada; e-mail: hannah.wunsch@sunnybrook.ca


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(2):281-282. doi:10.1378/chest.14-2377
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The triage of patients for admission to ICUs is a topic of intense focus by researchers and clinicians.1 But the process of discharging a patient from the ICU also involves multiple parties and steps, starting with the decision of whether a patient is ready for discharge, progressing to discharge planning and actual discharge, and ending with follow-up after discharge.2,3 Because of the complexity of care requirements for critically ill patients, and the fact that this discharge transition occurs from a resource-rich to a relatively resource-poor environment, discharge from the ICU represents a potentially vulnerable time for patients. The decision to discharge may be premature, transfer itself may create medical errors, and patients and families may experience fear or dissatisfaction with care.4,5 A scoping review by Stelfox and colleagues3 in this issue of CHEST (see page 317) provides an impressive overview of the discharge process for a patient from the ICU to the hospital ward, highlights the many facets of the issue, and catalogs tools that have been previously reported to facilitate this process.

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