Night-time discharge for patients high in Scotland

Victoria Infirmary in Glasgow had the highest rate of ICU night time discharges. Picture: Stephen Mansfield

MORE than one in ten patients in Scottish critical care units last year had to be discharged during night-time hours, putting their recovery at risk, a report warns.

Overall 11 per cent of discharges from intensive care units (ICUs) and high dependency units (HDUs) to other wards took place between 8pm and 8am - a practice not recommended due to poorer outcomes for patients.

The report said that night time discharges took place to make room for other patients or were delayed from earlier in the day due to lack of beds elsewhere in the hospital.

The report also found that three per cent of discharges from critical care were classed as early, usually linked to lack of beds to cope with incoming patients.

The Scottish Intensive Care Society Audit Group (SICSAG) report for 2013 found that bed occupancy rates remained relatively stable at around 72 per cent for ICU and 78 per cent in HDU, but with considerable variation between units.

Night time admissions to ICU were 34 per cent and for HDU 33 per cent, which the report said highlighted the unpredictability of the service.

And the report found that 17 per cent of discharges from ICU and 19 per cent from HDU were delayed by more than six hours, with wide variation between units.

On the subject of night time discharges, the authors said these were linked to worse outcome for patients.

“Night time discharges are forced early discharges to accommodate another patient or delayed from earlier in the day due to inadequate ward beds. They may be poorly planned and/or communicated,” the report said.

“Patients perceive discharge at night as extremely unpleasant.”

The highest level of night time discharges from ICU was found at the Victoria Infirmary in Glasgow at 28 per cent in 2013, up from 15 per cent the previous year.