Table 2 Research questions, methods, study population, and outcome measures

A

What is the variation in patient outcomes regarding ICU discharges?

Analyzing variation in quality of care

Data from 2011 from adult patients of all Dutch ICUs participating in the NICE registry (n = 84).

ICU quality indicators, e.g.:

- ICU readmissions

- ICU and hospital mortality

B

What are effective interventions to improve the safety of the ICU discharge process?

Systematic review

Pubmed (including Medline), Cinahl, PsychInfo, Cochrane database, and EMBASE

Overview of effective interventions and effect sizes

C

What is the adherence to guidelines and effective ICU discharge interventions?

Questionnaire to explore guideline adherence and use of effective ICU discharge interventions

All Dutch ICUs (n = 94)

Scale implementation problem: adherence to ICU discharge guidelines and the use of effective interventions. Association between scores on ICU quality indicators (research question 1) and guidelines and intervention adherence (research question 2).

D

What are the barriers and facilitators to the implementation of guidelines and effective ICU discharge interventions?

Individual semi structured (n = 25–30) and focus group interviews (n = 4)

Intensivists, physicians, nurses and managers of ICUs and general wards and patients and their relatives.

Barriers and facilitators classified according to: (1) intervention characteristics; (2) societal context, (3) implementation characteristics, (4) institutional characteristics, (5) social context, (6) professional characteristics, and (7) patient characteristics.

Questionnaire to quantify the barriers and facilitators from the individual and focus group interviews

All Dutch intensivists (n = 700).

E

What is an appropriate strategy to implement effective interventions to improve the safety and efficiency of the ICU discharge procedure?

Intervention mapping with the method of Bartholomew and Kok (2011)

Matching the data from the interviews, focus groups and questionnaires to effective implementation strategies from the literature

Implementation strategy tailored to the found barriers and facilitators to the implementation of effective ICU discharge interventions