Although many ICU patients have complex discharge planning needs, traditionally ICUs have not focused on this aspect of transitional care,14,24,63 with a notable paucity of research in this area. Russell33suggests that the philosophical underpinnings of intensive care may account for this discrepancy. The focus in the ICU is on sustaining life during the episode of critical illness and not necessarily on the “life after life support.”33 As allocation of healthcare resources continues to tighten, this philosophical stance must evolve to reflect the fluidity of care boundaries. Discharge planning must anticipate care beyond the walls of the ICU.
The recognition of challenges in the transitional care of patients after their discharge from the ICU, or from any healthcare environment, has prompted researchers to develop transitional care strategies that may improve the short- and long-term physical and psychosocial outcomes for patients who have been critically ill. The future in the field of transitional care after the ICU lies in promoting a shift in the provision of hospital care and in developing a strong evidence base through rigorous research and evaluation. The knowledge gained from this highly transitional group of patients may provide much deeper understanding of the complex issues associated with transitional care, which may be adaptable for a broader range of patients, in diverse clinical settings.