Critical Illness
Conditions
Brief summary
The purpose of this study is to evaluate and compare outcomes of patients that have received care in medical intensive care units in a tertiary care facility with two different models; the traditional model including resident, pulmonary fellow and attending physician and a nontraditional model which has Nurse Practitioners as the direct care deliverer, a pulmonary fellow, and an attending.
Detailed description
This will be a retrospective cohort study that is performed between two medical intensive care units (ICU). The goal is to compare outcomes of patients that have received care in medical intensive care units in a tertiary care facility with two different models; the traditional model including a resident, pulmonary fellow and attending and a nontraditional model which has Nurse Practitioners as the direct care deliverer, a pulmonary fellow, and an attending. Outcomes that will be measured include ICU length of stay, hospital length of stay after ICU discharge, ventilator days, daily spontaneous breathing trials, and daily awakening trials, as well as mortality in hospital and after discharge.
Interventions
OTHERMedically directed care
There is no research directed care. Patients are treated as medically indicated.
Sponsors
Naeem Ali, MD
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients admitted to designated ICU between September 1, 2007 and September 30, 2010.
Exclusion criteria
* Not admitted to designated ICU.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Life-years hospital costs | 2007 - 2010 | Life-years per $10,000 hospital costs - defined as the sum of days of survival after ICU admission for all patients admitted to each ICU/sum of all hospital costs for all patients admitted to each ICU |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital mortality | 2007 - 2010 | — |
| Time to death | 2007 - 2010 | — |
| Ventilator Days | 2007 - 2010 | — |
| Ventilator-free days | 2007 - 2010 | Days alive and not requiring mechanical ventilation in first 28 days after ICU admission |
| Intensive Care Unit (ICU)-free days | 2007 - 2010 | Days alive and not in the ICU in first 28 days after ICU admission |
| Evidence-based care | 2007 - 2010 | % of ICU days receiving evidence-based care will also be explored as mediators of other outcomes) * Sedation holidays * Spontaneous breathing trials * Days with continuous infusions of sedatives * Head of bed elevation |
| Intensive Care Unit (ICU) mortality | 2007 - 2010 | — |
| Intensive Care Unit (ICU)Length of Stay (LOS) | 2007 - 2010 | — |
| Hospital Length of Stay (LOS) | 2007 - 2010 | — |
| Hospital costs | 2007 - 2010 | — |
| Hospital charges | 2007 - 2010 | — |
| Patient Satisfaction Survey Results | 2007 - 2010 | — |
| Discharge location among survivors | 2007 - 2010 | — |
Countries
United States
Outcome results
None listed