کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5886173 1150931 2014 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
OutcomesThe association of intensivists with failure-to-rescue rates in outlier hospitals: Results of a national survey of intensive care unit organizational characteristics
ترجمه فارسی عنوان
نتایج انجمن ارتباطات فشرده سازان با نرخ ناتوانی در بیمارستان های خارج از کشور: نتایج یک بررسی ملی در خصوص ویژگی های سازمانی واحد مراقبت های ویژه
کلمات کلیدی
شکست نجات کیفیت ایمنی، پاسخ سریع، رفتار سازمانی، مراقبتهای ویژه،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

PurposeCritical care is often an integral part of rescue for patients with surgical complications. We sought to understand critical care characteristics predictive of failure-to-rescue (FTR) performance at the hospital level.MethodsUsing 2009 to 2011 FTR data from Hospital Compare, we identified 144 outlier hospitals with significantly better/worse performance than the national average. We surveyed intensive care unit (ICU) directors and nurse managers regarding physical structures, patient composition, staffing, care protocols, and rapid response teams (RRTs). Hospitals were compared using descriptive statistics and logistic regression.ResultsOf 67 hospitals completing the survey, 56.1% were low performing, and 43.9% were high performing. Responders were more likely to be teaching hospitals (40.9% vs 25.0%; P = .05) but were similar to nonresponders in terms of size, region, ownership, and FTR performance. Poor performers were more likely to serve higher proportions of Medicaid patients (68.4% vs 20.7%; P < .0001) and be level 1 trauma centers (55.9% vs 25.9%; P = .02). After controlling for these 2 characteristics, an intensivist on the RRT (adjusted odds ratio, 4.27; confidence interval, 1.45-23.02; P = .005) and an internist on staff in the ICU (adjusted odds ratio, 2.13; P = .04) were predictors of high performance.ConclusionsIntensivists on the RRT and internists in the ICU may represent discrete organizational strategies for improving patient rescue. Hospitals with high Medicaid burden fare poorly on the FTR metric.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Critical Care - Volume 29, Issue 6, December 2014, Pages 930-935
نویسندگان
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