Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital Export

@article{citeulike:1613966, abstract = {OBJECTIVE: The purpose of the study was to investigate the effects of introducing a critical care outreach service on in-hospital mortality and length of stay in a general acute hospital. DESIGN: A pragmatic ward-randomised trial design was used, with intervention introduced to all wards in sequence. No blinding was possible. SETTING: Sixteen adult wards in an 800-bed general hospital in the north of England. PATIENTS AND PARTICIPANTS: All admissions to the 16 surgical, medical and elderly care wards during 32-week study period were included (7450 patients in total, of whom 2903 were eligible for the primary comparison). INTERVENTIONS: Essential elements of the Critical Care Outreach service introduced during the study were a nurse-led team of nurses and doctors experienced in critical care, a 24-h service, emphasis on education, support and practical help for ward staff. MEASUREMENTS AND RESULTS: The main outcome measures were in-hospital mortality and length of stay. Outreach intervention reduced in-hospital mortality compared with control (two-level odds ratio: 0.52 (95\% CI 0.32-0.85). A possible increased length of stay associated with outreach was not fully supported by confirmatory and sensitivity analyses. CONCLUSIONS: The study suggests outreach reduces mortality in general hospital wards. It may also increase length of stay, but our findings on this are equivocal.}, address = {York Hospitals NHS Trust, Bootham Park, York, YO30 7BY, UK.}, author = {Priestley, George and Watson, Wendy and Rashidian, Arash and Mozley, Caroline and Russell, Daphne and Wilson, Jonathan and Cope, Judith and Hart, Dianne and Kay, Diana and Cowley, Karen and Pateraki, Jayne}, citeulike-article-id = {1613966}, citeulike-linkout-0 = {http://dx.doi.org/10.1007/s00134-004-2268-7}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/15112033}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=15112033}, citeulike-linkout-3 = {http://www.springerlink.com/content/l4vg8va45xr4pa0p}, day = {10}, doi = {10.1007/s00134-004-2268-7}, issn = {0342-4642}, journal = {Intensive Care Medicine}, keywords = {care, critical, ews, levels, of, outreach}, month = {July}, number = {7}, pages = {1398--1404}, posted-at = {2009-10-28 23:08:54}, priority = {2}, title = {Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital}, url = {http://dx.doi.org/10.1007/s00134-004-2268-7}, volume = {30}, year = {2004} }

TY - JOUR ID - citeulike:1613966 L3 - citeulike-article-id:1613966 N2 - OBJECTIVE: The purpose of the study was to investigate the effects of introducing a critical care outreach service on in-hospital mortality and length of stay in a general acute hospital. DESIGN: A pragmatic ward-randomised trial design was used, with intervention introduced to all wards in sequence. No blinding was possible. SETTING: Sixteen adult wards in an 800-bed general hospital in the north of England. PATIENTS AND PARTICIPANTS: All admissions to the 16 surgical, medical and elderly care wards during 32-week study period were included (7450 patients in total, of whom 2903 were eligible for the primary comparison). INTERVENTIONS: Essential elements of the Critical Care Outreach service introduced during the study were a nurse-led team of nurses and doctors experienced in critical care, a 24-h service, emphasis on education, support and practical help for ward staff. MEASUREMENTS AND RESULTS: The main outcome measures were in-hospital mortality and length of stay. Outreach intervention reduced in-hospital mortality compared with control (two-level odds ratio: 0.52 (95% CI 0.32-0.85). A possible increased length of stay associated with outreach was not fully supported by confirmatory and sensitivity analyses. CONCLUSIONS: The study suggests outreach reduces mortality in general hospital wards. It may also increase length of stay, but our findings on this are equivocal. IS - 7 JF - Intensive Care Medicine SN - 0342-4642 AD - York Hospitals NHS Trust, Bootham Park, York, YO30 7BY, UK. EP - 1404 TI - Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital VL - 30 SP - 1398 KW - care KW - critical KW - ews KW - levels KW - of KW - outreach AU - Priestley, George AU - Watson, Wendy AU - Rashidian, Arash AU - Mozley, Caroline AU - Russell, Daphne AU - Wilson, Jonathan AU - Cope, Judith AU - Hart, Dianne AU - Kay, Diana AU - Cowley, Karen AU - Pateraki, Jayne PY - 2004/07/10/ UR - http://dx.doi.org/10.1007/s00134-004-2268-7 ER -