Structured interdisciplinary bedside rounds, in-hospital deaths, and new nursing home placements among older inpatients.
Clin Interv Aging
; 13: 2289-2294, 2018.
Article
en En
| MEDLINE
| ID: mdl-30519010
PURPOSE: Ineffective interdisciplinary communication is linked to many adverse consequences of hospitalization. This study evaluated the effect of SIBR, a model of care that encourages interdisciplinary communication and patient and family participations, on in-hospital deaths and new nursing home (NH) placements. MATERIALS AND METHODS: This before-after study included 3,673 consecutive inpatients of mean age 83.8 years, of whom 93.2% were admitted through the emergency department. After each twice-weekly SIBR session, an interdisciplinary care plan was implemented and recorded on a datasheet attached to the bedside record. Staff unable to participate in SIBR were asked to view the datasheet and to follow the care plan. Logistic regression models were computed for in-hospital deaths and new NH placements. RESULTS: Although SIBR implementation had no effect on in-hospital deaths (OR, 1.00; 95% CI, 0.77-1.29), SIBR increased NH placements among those who survived the hospitalization (n=3,346) in both unadjusted (14.6% vs 9.1%; P<0.001) and adjusted (OR, 1.75; 95% CI, 1.38-2.23) analyses. CONCLUSION: Although the mechanisms between SIBR implementation and NH placement remain uncertain, SIBR may encourage patients and families to make decisions on placement earlier than they would have otherwise. Models of care aiming to improve communication should be evaluated across diverse services and settings to determine effectiveness and to monitor for adverse findings.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Planificación de Atención al Paciente
/
Grupo de Atención al Paciente
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Mortalidad Hospitalaria
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Comunicación Interdisciplinaria
/
Casas de Salud
Tipo de estudio:
Guideline
/
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Aged
/
Aged80
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Female
/
Humans
/
Male
Idioma:
En
Revista:
Clin Interv Aging
Asunto de la revista:
GERIATRIA
Año:
2018
Tipo del documento:
Article
Pais de publicación:
Nueva Zelanda