Variability in outcome and resource use in intensive care units

Rothen, Hans Ulrich; Stricker, Kay H.; Einfalt, J T; Bauer, Péter; Metnitz, Ph. G. H.; Moreno, Rui P.; Takala, Jukka

doi:10.1007/s00134-007-0690-3

Cited by 116 publications

(106 citation statements)

References 44 publications

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“…The lower satisfaction observed in ICUs with written admission/discharge policies was an unexpected finding and is difficult to explain. Indeed, some organizational parameters have been found to improve resource use and outcome [4]. In the present study, however, apart from the patient:nurse ratio, no other organizational parameter was associated with increased satisfaction.…”

Section: Discussioncontrasting

confidence: 67%

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Family satisfaction in the intensive care unit: what makes the difference?

et al. 2009

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Purpose: To assess family satisfaction in the ICU and to identify parameters for improvement. Methods: Multicenter study in Swiss ICUs. Families were given a questionnaire covering overall satisfaction, satisfaction with care and satisfaction with information/decision-making. Demographic, medical and institutional data were gathered from patients, visitors and ICUs. Results: A total of 996 questionnaires from family members were analyzed. Individual questions were assessed, and summary measures (range 0-100) were calculated, with higher scores indicating greater satisfaction. Summary score was 78 ± 14 (mean ± SD) for overall satisfaction, 79 ± 14 for care and 77 ± 15 for information/decisionmaking. In multivariable multilevel linear regression analyses, higher severity of illness was associated with higher satisfaction, while a higher patient:nurse ratio and written admission/discharge criteria were associated with lower overall satisfaction. Using performanceimportance plots, items with high impact on overall satisfaction but low satisfaction were identified. They included: emotional support, providing understandable, complete, consistent information and coordination of care. Conclusions: Overall, proxies were satisfied with care and with information/decision-making. Still, several factors, such as emotional support, coordination of care and communication, are associated with poor satisfaction, suggesting the need for improvement.

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Section: Discussioncontrasting

confidence: 67%

“…Over time, interest has focused on additional aspects, such as quality of life [1,2], processes of care [3] and resource use [4]. Recently, outcome research has been extended to the care of patients and their next of kin [5].…”

Section: Introductionmentioning

confidence: 99%

Family satisfaction in the intensive care unit: what makes the difference?

et al. 2009

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“…Previous comparisons of case-mixadjusted ICU length of stay across units also have demonstrated significant differences in OMELOS across units (7)(8)(9)(10)(11)(12)(13)(14). Some of these studies assessed the association between ICU OMELOS with standardized mortality ratios across multiple units and found that little association existed (7)(8)(9).…”

Section: Discussionmentioning

confidence: 89%

The relationship between hospital and intensive care unit length of stay*

Kramer

Zimmerman²

2011

Critical Care Medicine

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“…-Presence of inter-professional clinical rounds [46] -Standardized and structured processes of handover and of interdisciplinary and interprofessional information transfer -Use of a clinical information system (patient data management system) Finally, although beyond the scope of these recommendations, it needs to be mentioned that a growing body of literature indicates that management and climate in the ICU can influence the satisfaction of patient relatives, the well-being of health care workers, and might even have an impact on patient outcomes [9-11, 47, 48].…”

Section: Activity Criteriamentioning

confidence: 99%