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The REcovery FoLlowing Intensive CarE Treatment (REFLECT) research programme is funded by a grant awarded by the NIHR Research for Patient Benefit scheme.

Most patients discharged from an intensive care unit (ICU) are expected to go home. However, about 1 in 12 die unexpectedly on general wards before leaving hospital. The high death rate occurs despite hospitals using
‘early warning’ scoring systems and visits from ICU teams. A plan which reduces this death rate is urgently needed. We will use several approaches to make sure that we get a clear picture of how to improve care. We will:

 Talk to patients, relatives, and staff with experience of ward care after ICU
 Look at the notes of patients cared for in wards after discharge from ICU.
 Look at published research to find known ways of improving care in this patient group.

Patient representatives will help us use this information to design a plan to deliver better care to patients who have been in ICU, whilst they remain in hospital. Experts in introducing change will help design the best
intervention. This project will combine information from several sources with experts skilled at making plans work. This will allow us to make the best possible plan.

After this project, we want to test whether our plan could be put in place in our local hospitals to see if we could undertake a large trial.

Over 2300 lives would be saved in the UK each year if our plan worked and stopped only a quarter of the unexpected deaths in patients discharged from ICU.