Articles: outcome-assessment-health-care.
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Multicenter Study
Increases in Emergency Department Occupancy Are Associated With Adverse 30-day Outcomes.
The associations between emergency department (ED) crowding and patient outcomes have not been investigated comprehensively in different types of ED. The study objective was to examine the associations of changes over time in ED occupancy with patient outcomes in a sample of EDs that vary by size and location. A secondary objective was to explore whether the relationship between ED occupancy and patient outcomes differed by ED characteristics (size/type and medical and nursing staffing ratios). ⋯ In Quebec EDs, increases in bed occupancy are associated with an increase in the rates of 30-day adverse outcomes, even after adjustment for patient and ED characteristics. The results raise important concerns about the quality of care during periods of ED crowding.
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Multicenter Study
North American Solitaire Stent Retriever Acute Stroke registry: post-marketing revascularization and clinical outcome results.
Limited post-marketing data exist on the use of the Solitaire FR device in clinical practice. The North American Solitaire Stent Retriever Acute Stroke (NASA) registry aimed to assess the real world performance of the Solitaire FR device in contrast with the results from the SWIFT (Solitaire with the Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers for thrombectomy revascularization of large vessel occlusions in acute ischemic stroke) trials. ⋯ The NASA registry demonstrated that the Solitaire FR device performance in clinical practice is comparable with the SWIFT and TREVO 2 trial results.
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Journal of patient safety · Sep 2014
Multicenter StudyThe relationship between nurse staffing and failure to rescue: where does it matter most?
This study further expands on the relationship between nurse staffing levels and patient outcomes, in particular, failure to rescue. Many studies are based on single-site hospitals or single-year data, thus limiting the generalizations of the findings. The purpose was to evaluate in a multisite multiyear study the relationship between unit-level nurse staffing and FTR mortality, for ICU and non-ICU patients. ⋯ We did not observe any of the expected associations between the nurse staffing variables and FTR for either general care unit or ICU discharges. The comprehensive risk adjustments provided adequate "leveling of the playing field" to evaluate the impact of unit-based nurse staffing levels on FTR mortality. Future studies should evaluate the influence of unit environment and patient risk.
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Multicenter Study
Hospital readmission and healthcare utilization following sepsis in community settings.
Sepsis, the most expensive cause of hospitalization in the United States, is associated with high morbidity and mortality. However, healthcare utilization patterns following sepsis are poorly understood. ⋯ Postsepsis survival and healthcare utilization were most strongly influenced by patient factors already present prior to sepsis hospitalization.
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J Orthop Sports Phys Ther · Aug 2014
Multicenter StudyMinimum important differences for the patient-specific functional scale, 4 region-specific outcome measures, and the numeric pain rating scale.
Multicenter, prospective, longitudinal cohort study. ⋯ We reported the MID for small, medium, and large patient-perceived change on the PSFS, NPRS, Oswestry Disability Index, Neck Disability Index, Upper Extremity Functional Index, and Lower Extremity Functional Scale for use in clinical practice and research.