HEALTHCARE QUALITY AND SAFETY
Year : 2015 | Volume
: 1 | Issue : 1 | Page : 3--8
Advanced practitioner-driven critical care outreach to reduce intensive care unit readmission mortality
Niels Douglas Martin1, Michael A Pisa2, Tara Ann Collins2, Matthew P Robertson2, Corinna P Sicoutris2, Naveena Bushan2, Jason Saucier2, Amanda Martin2, Patrick M Reilly1, Meghan Lane-Fall3, Benjamin Kohl3
1 Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
2 Department of Advanced Practice, Hospital of the University of Pennsylvania, Philadelphia, USA
3 Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
Objectives: Intensive care unit (ICU) readmission is associated with poorer outcomes as compared to primary admissions. Recognizing new or recurrent critical care issues on the wards postICU discharge may improve outcomes, especially in those subsequently requiring readmission. Herein, we describe and evaluate a pilot surgical critical care outreach initiative to reduce mortality in patients ultimately requiring ICU readmission.
Methods: Each patient discharged from the ICU was visited within 48 h by a Critical Care Advanced practitioner who examined the patient, reviewed the chart, recent laboratory results, and orders, and then communicated any concerns to the primary service. Patient demographics, outreach issues identified, and severity of issues were recorded prospectively. Retrospectively, patient outcomes were assessed including the need and timing of any ICU readmission and mortality both before and after outreach implementation.
Results: Pre and postoutreach readmission rates were 2.41% (37/1534) versus 3.54% (54/1524), respectively (P = 0.07). Mortality rates before and after outreach were 5.08% (n = 78) versus 5.64% (n = 86) overall (P = 0.052) and 18.9% (n = 7) versus 9.25% (n = 5) for readmissions (P = 0.21), respectively.
Conclusions: Critical care outreach postICU discharge did not decrease readmission mortality in this pilot study. Further studies are required to evaluate its effects on not only readmission mortality but also readmission rates and timing along with the incident of subsequent ICU complications.
The following core competencies are addressed in this article: Patient care, Systems based practice, Communication.
Niels Douglas Martin
Medical Office Building Suite 120 (Trauma), 51 North 39th Street, Philadelphia, PA 19104
|How to cite this article:|
Martin ND, Pisa MA, Collins TA, Robertson MP, Sicoutris CP, Bushan N, Saucier J, Martin A, Reilly PM, Lane-Fall M, Kohl B. Advanced practitioner-driven critical care outreach to reduce intensive care unit readmission mortality.Int J Acad Med 2015;1:3-8
|How to cite this URL:|
Martin ND, Pisa MA, Collins TA, Robertson MP, Sicoutris CP, Bushan N, Saucier J, Martin A, Reilly PM, Lane-Fall M, Kohl B. Advanced practitioner-driven critical care outreach to reduce intensive care unit readmission mortality. Int J Acad Med [serial online] 2015 [cited 2022 Sep 28 ];1:3-8
Available from: https://www.ijam-web.org/article.asp?issn=2455-5568;year=2015;volume=1;issue=1;spage=3;epage=8;aulast=Martin;type=0