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The correlation between intensive care unit attending physician continuity of care with financial and clinical outcomes
Author(s) -
Selvam Pooja V.,
Furqan Muhammad M.,
York Sarah,
Vaidya Dhananjay,
Hoang Etter,
Trost Jeffrey C.,
Williams Marlene S.,
ChandraStrobos Nisha,
Zakaria Sammy
Publication year - 2018
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12949
Subject(s) - medicine , intensive care unit , cohort , retrospective cohort study , emergency medicine , intensive care , family medicine , intensive care medicine
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.