Intensive care unit readmission prevention checklist: Is it worth the effort?

作者: Nathan J. Smischney , Kelly A. Cawcutt , John C. O'Horo , Ronaldo A. Sevilla Berrios , Francis X. Whalen

DOI: 10.1111/JEP.12135

关键词: Quality managementEmergency departmentEmergency medicineMedical emergencyChecklistMedicineObservational studyBaseline dataUnplanned readmissionIntensive care unitInitial phase

摘要: Rationale, aims and objectives Checklists have been adopted by various institutions to improve patient outcomes. In particular, readmission prevention checklists may be of potential value care reduce medical costs. As a result, prior quality improvement study was conducted create an intensive unit checklist. The previous pilot demonstrated zero readmissions when the checklist utilized but yielded low compliance (30%). Thus, subsequent initiative undertaken refine with primary aim improved while maintaining reduced rate that observed original study. Method A single-centre, cross-sectional for assessing baseline data prospective observational assess effectiveness refined tool in 20-bed tertiary medical-surgical at academic centre Rochester, MN conducted. Medical patients admitted through emergency department, upon direct transfer from outside facility, post-operative surgical our institution were included. administered during 8-week period patients. Results resulted even lower (10.5%) initial phase likely resulting utilization paper electronic environment. Moreover, 22% unplanned which utilized. Conclusions conclusion, findings current serve rethink process health delivery applies tools

参考文章(14)
M Michael Shabot, Scott A Cunneen, Matthew T Wilson, Daniel R Margulies, Gregg K Nishi, Richard H Suh, Analysis of causes and prevention of early readmission to surgical intensive care. American Surgeon. ,vol. 69, pp. 913- 917 ,(2003)
Philipp G. H. Metnitz, Fabienne Fieux, Barbara Jordan, Thomas Lang, Rui Moreno, Jean-Roger Le Gall, Critically ill patients readmitted to intensive care units--lessons to learn? Intensive Care Medicine. ,vol. 29, pp. 241- 248 ,(2003) , 10.1007/S00134-002-1584-Z
V. Herasevich, A. Ahmed, O. Gajic, B.W. Pickering, Novel Representation of Clinical Information in the ICU: Developing User Interfaces which Reduce Information Overload. Applied Clinical Informatics. ,vol. 1, pp. 116- 131 ,(2010) , 10.4338/ACI-2009-12-CR-0027
Eiran Z Gorodeski, Randall C Starling, Eugene H Blackstone, None, Are all readmissions bad readmissions The New England Journal of Medicine. ,vol. 363, pp. 297- 298 ,(2010) , 10.1056/NEJMC1001882
Andrew A. Kramer, Thomas L. Higgins, Jack E. Zimmerman, The association between ICU readmission rate and patient outcomes. Critical Care Medicine. ,vol. 41, pp. 24- 33 ,(2013) , 10.1097/CCM.0B013E3182657B8A
Matthew M. Churpek, Trevor C. Yuen, Seo Young Park, David O. Meltzer, Jesse B. Hall, Dana P. Edelson, Derivation of a cardiac arrest prediction model using ward vital signs Critical Care Medicine. ,vol. 40, pp. 2102- 2108 ,(2012) , 10.1097/CCM.0B013E318250AA5A
Dean R. Hess, Arthur Tokarczyk, Mary O'Malley, Susan Gavaghan, Judith Sullivan, Ulrich Schmidt, The value of adding a verbal report to written handoffs on early readmission following prolonged respiratory failure. Chest. ,vol. 138, pp. 1475- 1479 ,(2010) , 10.1378/CHEST.09-2140
A. Rhodes, R. P. Moreno, E. Azoulay, M. Capuzzo, J. D. Chiche, J. Eddleston, R. Endacott, P. Ferdinande, H. Flaatten, B. Guidet, R. Kuhlen, C. León-Gil, M. C. Martin Delgado, P. G. Metnitz, M. Soares, C. L. Sprung, J. F. Timsit, A. Valentin, Prospectively defined indicators to improve the safety and quality of care for critically ill patients: a report from the Task Force on Safety and Quality of the European Society of Intensive Care Medicine (ESICM) Intensive Care Medicine. ,vol. 38, pp. 598- 605 ,(2012) , 10.1007/S00134-011-2462-3
Andrew L. Rosenberg, Charles Watts, Patients readmitted to ICUs* : a systematic review of risk factors and outcomes. Chest. ,vol. 118, pp. 492- 502 ,(2000) , 10.1378/CHEST.118.2.492
V C Burch, G Tarr, C Morroni, Modified early warning score predicts the need for hospital admission and inhospital mortality Emergency Medicine Journal. ,vol. 25, pp. 674- 678 ,(2008) , 10.1136/EMJ.2007.057661