Optimizing safety for patients transferred from intensive care units to general medical wards A SIMPLER approach (27 May 2025)

Summary

This paper identifies some of issues around transitions of care when a patient leaves an intensive care unit (ICU) for ‘a general medical ward (or other de-escalated care settings, such as a step-down unit) for observation, treatment, and discharge planning.’ The authors describe a checklist to support safe ICU transfers of patients to medical wards or step-down units. 

Content

The proposed 7-step checklist has the mnemonic SIMPLER:

1. Stable vital signs
2. Intact aeration
3. Medications reviewed
4. Prepared psychology
5. Lingering catheters
6. Extreme laboratory findings, and
7. Return plans.

The authors state: "The first 3 steps are prerequisites in a medical ward and denote the importance of stable vitals signs, intact aeration, and a diligent medication check. The next 3 steps are priorities in the ICU and involve determining patient expectations, managing catheters or other devices, and reviewing laboratory results. The final step concerns contingency plans for unforeseen deteriorations and goals of care."