tailieunhanh - Báo cáo y học: "Figuring out what works: a need for more and better studies on the relationship between ICU organization and outcomes"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Figuring out what works: a need for more and better studies on the relationship between ICU organization and outcomes. | Garland Critical Care 2010 14 108 http content 14 1 108 CRITICAL CARE COMMENTARY L__ Figuring out what works a need for more and better studies on the relationship between ICU organization and outcomes Allan Garland See related research by Billington etal. http content 13 6 R209 Abstract Modifying how intensive care units ICUs are organized and run offers major opportunities to improve outcomes. In the previous issue of Critical Care Billington and colleagues assessed the association of outcomes with intensivists base speciality. However very little is known about the relationships between ICU organization and outcomes. In the systems-based paradigm of quality improvement every aspect of what we do and how we do it is a candidate for study and change. While we need much more rigorous research assessing every aspect of this large question there are substantial barriers to conducting such studies. In the previous issue of Critical Care Billington and colleagues 1 presented an intriguing study assessing differences in intensive care unit ICU outcomes and resource use according to the base specialty of intensivists. While certain to be controversial this type of research is important and we need much more of it. But first details about the study itself. This retrospective statistical analysis used data from three medical-surgical ICUs in Calgary Alberta. All are closed ICUs with house staff and a single intensivist in charge for each block of time. Multivariable regression was used to evaluate the association of outcomes and resource use with the specialty training of their 26 intensivists. Specialties were divided into three groups a internal medicine b internal medicine and pulmonary subspecialty or c all others representing anesthesia surgery and emergency medicine. Correspondence agarland@ University of Manitoba Health Sciences Centre 820 Sherbrook Street - GF222 Winnipeg MB Canada R3A 1R9 2 BioMed Central 2010 BioMed .