G Baldock1, P Foley, S Brett. 1. Department of Anaesthesia and Intensive Care, Hammersmith Hospital, London, UK. g.baldock@ic.ac.uk
Abstract
OBJECTIVES: To study the change in outcome for patients admitted to an intensive care unit following the establishment of a team of resident medical staff and a change from an "open" to a "closed" organisational format. DESIGN: Database review of prospectively collected data. SETTING: Intensive care unit of a postgraduate teaching hospital. SUBJECTS: 1134 admissions to the intensive care unit over a 3-year period, of whom 476 (42%) followed elective surgery. MAIN OUTCOME MEASURE: Hospital mortality corrected for illness severity by using the APACHE II scoring system. RESULTS: Crude hospital mortality fell from 28% before the changes to 20% afterwards (P = 0.01). With correction for case-mix factors, the probability of death after the changes was reduced by almost half (OR 0.51; CI 0.32, 0.82, P = 0.005). CONCLUSION: A "closed" format of organisation of the delivery of care may result in improved outcomes for patients admitted to intensive care units.
OBJECTIVES: To study the change in outcome for patients admitted to an intensive care unit following the establishment of a team of resident medical staff and a change from an "open" to a "closed" organisational format. DESIGN: Database review of prospectively collected data. SETTING: Intensive care unit of a postgraduate teaching hospital. SUBJECTS: 1134 admissions to the intensive care unit over a 3-year period, of whom 476 (42%) followed elective surgery. MAIN OUTCOME MEASURE: Hospital mortality corrected for illness severity by using the APACHE II scoring system. RESULTS: Crude hospital mortality fell from 28% before the changes to 20% afterwards (P = 0.01). With correction for case-mix factors, the probability of death after the changes was reduced by almost half (OR 0.51; CI 0.32, 0.82, P = 0.005). CONCLUSION: A "closed" format of organisation of the delivery of care may result in improved outcomes for patients admitted to intensive care units.
Authors: Jonathan P Singer; Jeffrey Kohlwes; Stephen Bent; Leslie Zimmerman; Mark D Eisner Journal: J Intensive Care Med Date: 2010-07 Impact factor: 3.510
Authors: Meeta Prasad Kerlin; Andrew Epstein; Jeremy M Kahn; Theodore J Iwashyna; David A Asch; Michael O Harhay; Sarah J Ratcliffe; Scott D Halpern Journal: Ann Am Thorac Soc Date: 2018-03
Authors: William Checkley; Greg S Martin; Samuel M Brown; Steven Y Chang; Ousama Dabbagh; Richard D Fremont; Timothy D Girard; Todd W Rice; Michael D Howell; Steven B Johnson; James O'Brien; Pauline K Park; Stephen M Pastores; Namrata T Patil; Anthony P Pietropaoli; Maryann Putman; Leo Rotello; Jonathan Siner; Sahul Sajid; David J Murphy; Jonathan E Sevransky Journal: Crit Care Med Date: 2014-02 Impact factor: 7.598
Authors: Frederik J van der Sluis; Cornelis Slagt; Barbara Liebman; Jan Beute; Jan W R Mulder; Alexander F Engel Journal: BMC Surg Date: 2011-08-23 Impact factor: 2.102
Authors: Rakesh C Arora; Erika Lee; David E Kent; Mina Asif; Yoan Lamarche; Ansar Hassan; Jean Francois Legare; Brett Hiebert Journal: CJC Open Date: 2021-07-14