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Cited by 66Hospital Admissions and OutcomesHealthcare Quality and ManagementFamily and Patient Care in Intensive Care Units

Impact of an outreach team on re-admissions to a critical care unit.

Open access
Leary, T., Ridley, S.·2003·Anaesthesia
DOI 10.1046/j.1365-2044.2003.03077.x
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Abstract

Summary Re‐admissions have been cited as a measure of critical care quality and outreach teams have recently been introduced to improve critical care delivery. The aim of this study was to examine whether the number, causes and sequence of re‐admissions to critical care altered as a result of the introduction of an outreach team. Re‐admissions between April 2000 and November 2001 were examined. The reasons for re‐admission were classified as (i) same pathology or disease process; (ii) new, but related, pathology; (iii) new and unrelated pathology; (iv) exacerbation of other comorbidities. During the two‐year period, a total of 2546 patients were admitted to critical care of which 100 were re‐admitted (49 before outreach and 51 after outreach). The reasons for re‐admission did not vary before or after the introduction of the outreach team (same pathology 15 vs. 15; new, but related, pathology 17 vs. 23; new, but unrelated, 14 vs. 9; exacerbation of comorbidity 3 vs. 4, respectively, Chi‐squared = 2.07, df = 3, p = 0.56). There was also no difference between the duration of stay on the general ward in between the critical care unit admissions before (median 2.93 [interquartile range 1.32–6.05] days) or after (median 2.25 [interquartile range 1.06–6.32] days) the introduction of an outreach team. As we could not detect any change in patterns of re‐admissions as a result of the introduction of an outreach team, we would suggest that although outreach is an important development for critical care, its performance should be measured by other parameters.

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  • No significant differences existed between the two insulin initiation blood glucose levels evaluated.

    “No significant differences existed between the two-insulin initiation blood glucose levels evaluated.”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [519]

    The Results (pp. 328–332) compare critical-care readmissions before and after an outreach team was introduced. Searches for insulin initiation, blood glucose levels, and glycemic thresholds found no passage addressing the claimed comparison. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • A network meta-analysis of 35 RCTs found no significant difference in the risk of hospital mortality between four blood glucose ranges (< 110, 110-144, 144-180, and > 180 mg/dL).

    “No significant difference in the risk of hospital mortality was observed between the four blood glucose ranges.”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [519]

    The Results and Discussion passages report mortality in patients readmitted to critical care before and after an outreach team was introduced; they do not compare blood-glucose ranges. Searches for the stated ranges, a 35-RCT network meta-analysis, and glycemic control found no passage addressing the claim. Section-level locations are available, but passage page numbers are not. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Target concentrations of < 110 and 110-144 mg/dL were associated with a four- to nine-fold increase in the risk of hypoglycemia compared with 144-180 and > 180 mg/dL.

    “Target concentrations of < 110 and 110-144 mg/dL were associated with a four-to nine-fold increase in the risk of hypoglycemia compared with 144-180 and > 180 mg/dL.”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [519]

    The Results section reports critical-care readmissions before and after an outreach team was introduced, not glucose targets or hypoglycemia. Searches for the stated target ranges and for blood glucose, glycemic control, and hypoglycemia found no passage addressing the claimed four- to nine-fold risk. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • No significant difference in the risk of hypoglycemia was demonstrated comparing a target of 144-180 and > 180 mg/dL (OR, 1.72; 95% CI, 0.79-3.7).

    “No significant difference in the risk of hypoglycemia comparing a target of 144-180 and > 180 mg/dL was demonstrated (OR, 1.72; 95% CI, 0.79-3.7).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [519]

    The Results (Anaesthesia 2003, pp. 328–332; passage page unspecified) compare critical-care readmissions before and after an outreach team was introduced. Searches for hypoglycemia, blood-glucose targets, and the reported odds ratio found no passage addressing the claimed comparison. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Several randomized studies have assessed physical rehabilitation programs for survivors of critical illness.

    “Several randomized studies have assessed physical rehabilitation programs for survivors of critical illness (581,606,(644)(645)(646)(647)(648)(649)(650)(651).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [606]

    The Discussion (page not available in our copy) discusses studies of critical-care outreach services, not physical rehabilitation for survivors of critical illness. A search for randomized rehabilitation trials found no passage addressing the claim. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 1

  1. [17]17. Smith GB, Nolan J. Results may have been due to education of ward staff. British Medical Journal 2002; 324: 1215.

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Authors
Leary, T., & Ridley, S.
Affiliations
Norfolk and Norwich University Hospital (GB)
Corresponding author
Leary, T.
ORCID
Ridley, S.
Venue
Anaesthesia
Publisher
Wiley
Published
2003-03-18
Volume
58
Issue
4
Pages
328-332
ISSN
  • 0003-2409 (ISSN-L)
  • 1365-2044
DOI
10.1046/j.1365-2044.2003.03077.x
OpenAlex
W2072669160
Semantic Scholar
3184feb04e3de36da99f4a21491c9555e5230fc9
Cited by
66
References
18
Citations by year
2025: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2017: 7 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 2
FWCI
9.34
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Anaesthesia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
Keywords
hospital readmission, intensive care unit admission, critical care quality
MeSH terms
Adult, Aftercare, Aged, Aged, 80 and over, Continuity of Patient Care, Critical Care, England, Female, Health Services Research, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Organizational Innovation, Patient Care Team, Patient Readmission, Quality of Health Care, State Medicine

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