JOURNAL ARTICLE

Patient flow variability and unplanned readmissions to an intensive care unit

David R Baker, Peter J Pronovost, Laura L Morlock, Romergryko G Geocadin, Christine G Holzmueller
Critical Care Medicine 2009, 37 (11): 2882-7
19866504

OBJECTIVE: To determine whether high patient inflow volumes to an intensive care unit are associated with unplanned readmissions to the unit.

DESIGN: Retrospective comparative analysis.

SETTING: The setting is a large urban tertiary care academic medical center.

PATIENTS: Patients (n = 3233) discharged from an adult neurosciences critical care unit to a lower level of care from January 1, 2006 through November 30, 2007.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: The main outcome variable is unplanned patient readmission to the neurosciences critical care unit within 72 hrs of discharge to a lower level of care. The odds of one or more discharges becoming an unplanned readmission within 72 hrs were nearly two and a half times higher on days when > or =9 patients were admitted to the neurosciences critical care unit (odds ratio, 2.43; 95% confidence interval, 1.39-4.26) compared with days with < or =8 admissions. The odds of readmission were nearly five times higher on days when > or =10 patients were admitted (odds ratio, 4.99; 95% confidence interval, 2.45-10.17) compared with days with < or =9 admissions. Adjusting for patient complexity, the odds of an unplanned readmission were 2.34 times higher for patients discharged to a lower level of care on days with > or =10 admissions to the neurosciences critical care unit (odds ratio, 2.34; 95% confidence interval, 1.27-4.34) compared with similar patients discharged on days of < or =9 admissions.

CONCLUSIONS: Days of high patient inflow volumes to the unit were associated significantly with subsequent unplanned readmissions to the unit. Furthermore, the data indicate a possible dose-response relationship between intensive care unit inflow and patient outcomes. Further research is needed to understand how to defend against this risk for readmission.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
19866504
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"