دورية أكاديمية
أعرض في EDS

Integrating a safety smart list into the electronic health record decreases intensive care unit length of stay and cost.

التفاصيل البيبلوغرافية
العنوان: Integrating a safety smart list into the electronic health record decreases intensive care unit length of stay and cost.
المؤلفون: Lemkin DL; Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Stryckman B; Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Klein JE; University of Maryland Medical System, Baltimore, MD, USA., Custer JW; Division of Pediatric Critical Care, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA., Bame W; Data & Analytics, University of Maryland Medical System Baltimore, MD, USA., Maranda L; Department of Quantitative Sciences, University of Massachusetts, Worcester, MA, USA., Wood KE; Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA., Paulson C; Department of Decision, Operations, and Information Technologies, University of Maryland Robert H. Smith School of Business, College Park, MD, USA., Dezman ZDW; Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: zdezman@som.umaryland.edu.
المصدر: Journal of critical care [J Crit Care] 2020 Jun; Vol. 57, pp. 246-252. Date of Electronic Publication: 2019 Oct 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8610642 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-8615 (Electronic) Linking ISSN: 08839441 NLM ISO Abbreviation: J Crit Care Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia Pa : W.B. Saunders
Original Publication: Orlando, FL : Grune & Stratton, c1986-
مواضيع طبية MeSH: Checklist* , Electronic Health Records* , Intensive Care Units* , Length of Stay*, Critical Illness/*therapy, Adult ; Aged ; Catheterization ; Cohort Studies ; Critical Illness/economics ; Female ; Health Care Costs ; Humans ; Male ; Medical Informatics ; Middle Aged ; Propensity Score ; Proportional Hazards Models ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Software ; User-Computer Interface ; Ventilators, Mechanical
مستخلص: Purpose: To measure how an integrated smartlist developed for critically ill patients would change intensive care units (ICUs) length of stay (LOS), mortality, and charges.
Materials and Methods: Propensity-score analysis of adult patients admitted to one of 14 surgical and medical ICUs between June 2017 and May 2018. The smart list aimed to certain preventative measures for all critical patients (e.g., removing unneeded catheters, starting thromboembolic prophylaxis, etc.) and was integrated into the electronic health record workflows at the hospitals under study.
Results: During the study period, 11,979 patients were treated in the 14 participating ICUs by 518 unique providers. Patients who had the smart list used during ≥60% of their ICU stay (N = 432 patients, 3.6%) were significantly more likely to have a shorter ICU LOS (HR = 1.20, 95% CI:1.0 to 1.4, p = 0.015) with an average decrease of -$1218 (95% CI: -$1830 to -$607, P < 0.001) in the amount charged per day. The intervention cohort had fewer average ventilator days (3.05 vent days, SD = 2.55) compared to propensity score matched controls (3.99, SD = 4.68, p = 0.015), but no changes in mortality (16.7% vs 16.0%, p = 0.78).
Conclusions: An integrated smart list shortened LOS and lowered charges in a diverse cohort of critically ill patients.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Checklist; Critical care; Electronic health records; Length of stay; Mortality
تواريخ الأحداث: Date Created: 20200109 Date Completed: 20210429 Latest Revision: 20210429
رمز التحديث: 20231215
DOI: 10.1016/j.jcrc.2019.09.016
PMID: 31911086
قاعدة البيانات: MEDLINE
الوصف
تدمد:1557-8615
DOI:10.1016/j.jcrc.2019.09.016