TY - JOUR
T1 - The correlation between intensive care unit attending physician continuity of care with financial and clinical outcomes
AU - Selvam, Pooja V.
AU - Furqan, Muhammad M.
AU - York, Sarah
AU - Vaidya, Dhananjay
AU - Hoang, Etter
AU - Trost, Jeffrey C.
AU - Williams, Marlene S.
AU - Chandra-Strobos, Nisha
AU - Zakaria, Sammy
N1 - Funding Information:
This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by grant UL1 TR001079 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS, or NIH.
Publisher Copyright:
© 2018 John Wiley & Sons, Ltd.
PY - 2018/8
Y1 - 2018/8
N2 - Purpose: “Attending rotations” on intensive care unit (ICU) services have been in place in most teaching hospitals for decades. However, the ideal frequency of patient care handoffs is unknown. Frequent attending physician handoffs could result in delays in care and other complications, while too few handoffs can lead to provider burnout and exhaustion. Therefore, we sought to determine the correlation between frequency of attending shifts with ICU charges, 30-day readmission rates, and mortality rates. Methods: We performed a retrospective cohort study at a large, urban, academic community hospital in Baltimore, MD. We included patients admitted into the cardiac or medical ICUs between September 1, 2012, and December 10, 2015. We tracked the number of attending shifts for each patient and correlated shifts with financial outcomes as a primary measure. Results: For any given ICU length of stay, we found no distinct association between handoff frequency and charges, 30-day readmission rates, or mortality rates. Conclusions: Despite frequent handoffs in care, there was no objective evidence of care compromise or differences in cost. Further validation of these observations in a larger cohort is justified.
AB - Purpose: “Attending rotations” on intensive care unit (ICU) services have been in place in most teaching hospitals for decades. However, the ideal frequency of patient care handoffs is unknown. Frequent attending physician handoffs could result in delays in care and other complications, while too few handoffs can lead to provider burnout and exhaustion. Therefore, we sought to determine the correlation between frequency of attending shifts with ICU charges, 30-day readmission rates, and mortality rates. Methods: We performed a retrospective cohort study at a large, urban, academic community hospital in Baltimore, MD. We included patients admitted into the cardiac or medical ICUs between September 1, 2012, and December 10, 2015. We tracked the number of attending shifts for each patient and correlated shifts with financial outcomes as a primary measure. Results: For any given ICU length of stay, we found no distinct association between handoff frequency and charges, 30-day readmission rates, or mortality rates. Conclusions: Despite frequent handoffs in care, there was no objective evidence of care compromise or differences in cost. Further validation of these observations in a larger cohort is justified.
KW - continuity of patient care
KW - hospital charges
KW - hospital mortality
KW - intensive care units
KW - patient handoffs
KW - patient readmission
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U2 - 10.1111/jep.12949
DO - 10.1111/jep.12949
M3 - Article
C2 - 29797761
AN - SCOPUS:85047615813
SN - 1356-1294
VL - 24
SP - 713
EP - 717
JO - Journal of Evaluation in Clinical Practice
JF - Journal of Evaluation in Clinical Practice
IS - 4
ER -