Articles: hospitals.
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Critical care medicine · Sep 2014
Multicenter StudyRapid Response Team Implementation and In-Hospital Mortality.
To determine the relationship between implementation of rapid response teams and improved mortality rate using a large, uniform dataset from one state in the United States. ⋯ In-hospital mortality improved in six of 10 acute tertiary care hospitals in the post-rapid response team time period when compared with the pre-rapid response team time period. Because of a long-term trend of decline in hospital mortality, these decreases could not be unambiguously attributed to rapid response team implementation. Further research should examine additional objective outcomes and optimal configuration of rapid response teams to maximize intervention effectiveness.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Multicenter Study Comparative Study Observational StudyMitral valve repair rates correlate with surgeon and institutional experience.
Mitral valve (MV) repair rates have lagged despite reported superior outcomes in patients with mitral regurgitation. The purpose of the present study was to evaluate the relationship between procedure volume and the propensity for MV repair in a multi-institution, regional patient cohort. ⋯ Significant variation in the performance of MV repair over MVR for mitral regurgitation persists in the modern surgical era. Average annual surgeon volume was more significantly associated with MV repair rate than institutional volume, with an increased likelihood for performance of MV repair among surgeons performing >20 procedures annually. In the upcoming era of percutaneous MV repair, surgeon volume and expertise as a gatekeeper should dictate access to this technology and the decisions for the best approach to MV repair.
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Multicenter Study
Surgeon and center volume influence on outcomes after arterial switch operation: analysis of the STS Congenital Heart Surgery Database.
The relative impact of center volume and of surgeon volume on early outcomes after the arterial switch operation (ASO) is incompletely understood. ⋯ Center and surgeon volume each influence early outcomes after ASO; however, surgeon volume appears to play a more prominent role. Surgeon and center ASO volume should be considered in the context of initiatives to improve outcomes from ASO for transposition of the great arteries.
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Multicenter Study Comparative Study
Public and private health service in Norway: a comparison of patient characteristics and surgery criteria for patients with nerve root affections due to discus herniation.
To compare sociodemographic, life style and clinical characteristics in patients operated for lumbar disc herniation in public and private clinics in Norway, and evaluate whether selection for surgery and surgical treatment were different across the two settings. ⋯ Patients having elective surgery due to lumbar disc herniation in public and private clinics were different with respect to many sociodemographic and life style variables. There were minor differences with respect to clinical variables and selection of patients for surgery, but substantial differences related to aspects of the surgical treatment.
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Multicenter Study
A multicentre feasibility study evaluating stress ulcer prophylaxis using hospital-based registry data.
It is unclear whether histamine-2 receptor blockers (H2RBs) or proton pump inhibitors (PPIs) are preferred for stress ulcer prophylaxis (SUP) in intensive care unit patients. Suitably powered comparative effectiveness trials are warranted. ⋯ It is feasible to use existing data sources to measure process-of-care and outcome data necessary for a registry-based interventional trial of SUP.