• Journal of critical care · Feb 2019

    Reducing night-time discharge from intensive care. A nationwide improvement project with public display of ICU outcomes.

    • Fredric Parenmark, Göran Karlström, Thomas Nolin, Mats Fredrikson, and Sten M Walther.
    • Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden; Department of Anaesthesia and Intensive Care, Gävle Hospital, Gävle, Sweden; Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. Electronic address: fredric.parenmark@criticalcare.se.
    • J Crit Care. 2019 Feb 1; 49: 7-13.

    PurposeDischarge from an intensive care unit (ICU) during the night is an independent risk factor for adverse outcomes. A quality improvement project was conducted with the aim of reducing the incidence and the associated mortality after night-time discharge.Materials And MethodsICUs that submitted data to the Swedish Intensive Care Registry (SIR) agreed to appoint night-time discharge as a national quality indicator with detailed public display on the internet of various discharge proportions and outcomes. The registry was then examined for trends during a 10-year period with use of multilevel mixed-effects models.ResultsWe analysed 163,371 patients who were discharged alive from 70 ICUs to a general ward within the same hospital during 2006-2015. The prevalence of night-time discharge fell from 7.0% (95% CI: 5.2 to 8.7%) in 2006 to 4.9% (95% CI: 4.3 to 5.5%) in 2015 (P = .035 for trend). The original increased risk of death within 30 days after night-time discharge in 2006-2010, OR 1.20 (95% CI: 1.01 to 1.42), disappeared in 2011-2015, OR 1.06 (95% CI: 0.96 to 1.17).ConclusionsDuring the 10-year period of the quality improvement project, the annual prevalence and risk of death within 30-days after night-time discharge were reduced. The public display and feedback of audit data could have helped in achieving this.Copyright © 2018 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…