Improving patient diary use in intensive care: A quality improvement report

Abstract

Background: Patients surviving critical illness are at risk of developing psychological symptoms that affect quality of life and recovery. Patient diaries may improve psychological outcomes by reducing gaps in memory and contextualising what has happened during admission. Factors including lack of guidelines, lack of awareness and time constraints may lead to poor diary use. Aims: This quality improvement project aimed to increase diary provision and overall multidisciplinary team engagement with diaries for all patients admitted for over 72 h to an intensive care unit. Methods: Trialled changes implemented via the ‘Plan-Do-Study-Act’ method included adding alerts to the online patient note system, providing education sessions and introducing a guidance document to facilitate entry completion. Results: A ‘diary provision’ target of 100% was achieved (from a baseline of 26.1%). Simple changes have proven effective in establishing routine engagement with diaries, and lessons may be used to improve diary systems elsewhere.