Effectiveness of rapid response call criteria: a systematic review and meta-analysis. Srinivas Bapoje (Denver Health Medical Center), Rinaldo Bellomo (University of Colorado Denver School of Medicine)
13 studies representing 416,797 patients were included. Only 41% of cardiopulmonary arrests and 19% of unexpected deaths are detected by rapid response screening criteria = low positive predictive value. The poor real-world operating characteristics of RRS calling criteria highlight the uncertain value of implementing RRSs to improve hospital outcomes.
CICLE: Creating incentives and continuity leading to efficiency. Shalini Chandra, Eric Howell (Johns Hopkins Bayview Medical Center)
The Joint Commission and Institute of Medicine have stressed that provider discontinuity of inpatient care poses many hazards to patiente care. This fragmentation is thought to threaten patienty safety and may influence length of stay, health care costs, and patient satisfaction. Our objective was to determine the impact of a hospitalist-developed continuity-centered staffing model (CICLE staffing model) on hand-offs, efficiency, and resource utilization.
Unique providers per admission declined by 13% under the CICLE model (p < 0,0001). The LOS decreased by 16% (p < 0,0001). Mean total hospital charge per admission fell approximately 20% (p < 0,0001), with significant savings in medications, laboratory charges, and radiology charges (all p < 0,0001). All-cause readmissions rates at 7, 15 and 30 days and paper-denied days were not affected.
Impact of a pediatric hospital medicine program on resource utilization for children with respiratory disorders. Nora Esteban-Cruciani (Children's Hospital at Montefiore, Albert Einstein College of Medicine)
Before and after the implementation of a pediatric HM program: LOS for asthma and bronchiolitis decreased significantly during the 40-month PHM program implementation period. There were no significant differences in 30-days ED returns-visits, readmission, or mortality rates. Estimated hospital-beds days saved at CHAM were 378/year (estimated savings/year = $943,866). Given the frequency of these conditions, a 12-15% reduction in LOS can potentially impact resource utilization nationwide and decrease the yearly "national bill" by approximately $350 million.
Hospitalists in medical education: Results from a national survey.
Hospitalists are involved in medical student education in the large majority of Departments of Internal Medicine throughout the United States and Canada. Many educational administration positions are held by hospitalists, reflecting the growth of hospital medicine nationally.
Work life and satisfaction of hospitalists.
The majority of hospitalists appear to drive job and specialty satisfaction, but domains that appear to drive job and specialty satisfaction warrant institutional attention: care quality, organizational climate, autonomy, compensation.
No ATS2011 foi apresentado outro trabalho sobre TRR's: Impact of a Rapid Response System in a Academic Hospital Center - Outcomes and Perceptions of Medicine Residents and Nurses. St. Luke's and Roosevelt Hospital Center, New York. Vou direto para as conclusões: The RRS was not associated with decreases in codes or mortality. Medicine housestaff and nurses share belief in the benefits of RRS.
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