Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: Non-randomised population based study.
Open accessAbstract
Objectives To determine the effect of the critical care outreach team on patient survival to discharge from hospital after discharge from critical care and readmission to critical care. Design Non-randomised population based study. Setting Tertiary referral teaching hospital with 1200 beds. Participants Patients discharged from the critical care unit after their first or only admission for two study periods, 26 February 2000 to 25 February 2001 and 26 February 2001 to 25 February 2002. Main outcome measures Survival to discharge from hospital after discharge from critical care and readmission to critical care. Results The introduction of a critical care outreach team improved survival to discharge from hospital after discharge from critical care by 6.8% (risk ratio 1.08). Readmission to critical care decreased by 6.4% (0.48). Conclusions The activity of the critical care outreach team seems to improve patient survival to discharge from hospital and may reduce the number of readmissions to critical care.
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Transfer from ICU to general floor and discharge from the hospital are both vulnerable periods for patients, with high frequency of medication errors and information loss.
“Transfer from ICU to general floor and discharge from the hospital are both vulnerable periods for patients, with high frequency of medication errors and information loss (596-602).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [600]
The Discussion (page not specified) says patients face increased risk of deterioration after discharge from critical care, supporting the vulnerability of the ICU-to-ward transition. It does not address vulnerability at hospital discharge or report a high frequency of medication errors or information loss; searches for those terms found no supporting passage. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA single-center study found that targeting blood glucose to 80-110 mg/dL reduced ICU mortality, but this finding was not reproduced in subsequent multicenter RCTs.
“In a single-center study, targeting blood glucose to 80-110 mg/dL reduced ICU mortality (513), however this finding was not reproduced in subsequent multicenter RCTs (514, 515).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [513]
The Strengths and limitations passage discusses a before-and-after study of a critical care outreach team, not blood-glucose targets. Searches for 80–110 mg/dL, glucose control, and insulin found no passage addressing the mortality finding attributed to this source. The later multicenter RCT finding is attached to other citations in the citing sentence. (LLM, conf=0.78)
Experimental — accuracy not yet measuredHospitalization and ICU admission are high-risk periods for unintentional medication error, including continuations of medications for temporary indications and unintentional discontinuations of chronic medications.
“Hospitalization and ICU admission are high-risk periods for unintentional medication error-both continuations of medications for temporary indications and unintentional discontinuations of chronic medications (596, 599, 600, 602).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [600]
The Data collection and Discussion sections address survival after discharge from critical care and readmission, not medication errors. A search for medication errors, temporary prescriptions, and discontinuation of chronic medications found no passage addressing the claim. The intervention table mentions requests for nebuliser therapy, but not whether any medication was continued or stopped unintentionally. (LLM, conf=0.78)
Experimental — accuracy not yet measuredSeveral studies, mostly before-and-after design, have examined critical care transition programmes on reducing ICU readmission or death among patients transferred from ICU to ward.
“Several studies, mostly before-and-after design, have examined the impact of critical care transition programmes on reducing ICU readmission or death among patients transferred from ICU to the ward [597, 601, 603–611].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [603]
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- Authors
- Ball, C., Kirkby, M., & Williams, S.
- Affiliations
- Royal Free London NHS Foundation Trust (GB)
- Corresponding author
- Ball, Carol
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2003-10-30
- Volume
- 327
- Issue
- 7422
- Pages
- 1014
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC261652
- OpenAlex
- W2158485463
- Cited by
- 270
- References
- 19
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 6 · 2020: 10 · 2019: 9 · 2018: 2 · 2017: 13 · 2016: 5 · 2015: 16 · 2014: 12 · 2013: 19 · 2012: 10
- FWCI
- 22.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
- Keywords
- patient survival, hospital discharge, intensive care unit, post-ICU care
- MeSH terms
- Aftercare, Aged, Continuity of Patient Care, Critical Care, England, Female, Hospitals, Teaching, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Patient Care Team, Patient Readmission, Critical Illness, Hospital Mortality
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