ArticleNeurocritical care2015
Mandatory Intensivist Management Decreases Length of Stay, Facilitates an Increase in Admissions and Minimizes Closure of a Neurocritical Care Unit.
Article in Neurocritical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Twitter Journal Club Impact on Engagement Metrics of the Neurocritical Care Journal.Neurocritical care · 2022Article
- The impact of intensive care unit physician staffing change at a community hospital.SAGE open medicine · 2022Article
- Current Status of Neurosurgical and Neurointensive Care Units in Korea : A Brief Report on Nationwide Survey Results.Journal of Korean Neurosurgical Society · 2020Article
- A Novel Neuroscience Intermediate-Level Care Unit Model: Retrospective Analysis of Impact on Patient Flow and Safety.The Neurohospitalist · 2017Article
- Evidence supports the superiority of closed ICUs for patients and families: Yes.Intensive care medicine · 2017Article
- Neuro-Intensivists as Effective Resource Managers. No, Really.Neurocritical care · 2015Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe primary objectives of this study were to identify patient and community benefits of mandatory intensivist management in a neurocritical care (NCC) unit. Our hospital recently mandated intensivist management for patients admitted to the NCC unit. As one of the only comprehensive stroke centers in Orlando, an unacceptably high number of patients were being denied admission because of overcapacity. We compared length of stay (LOS), complications, outcomes, total admissions, and emergency transfer center closure rates before and after implementation of mandatory intensivist management.
methodsA retrospective review comparing 1551 patients admitted to a 20 bed NCC unit from November 1, 2009 to October 31, 2010 (prior to mandatory intensivist management) with 1702 patients admitted from January 1, 2011 to December 31, 2011 (after the requirement) was performed. This included examining LOS, Acute Physiology and Chronic Health Evaluation III (APACHE) scores, service line closure rates, and mortality during both time periods.
resultsAnalysis revealed that despite comparable APACHE scores, implementation of mandatory intensivist management reduced overall NCC LOS, 4.6 versus 3.7 days, (p < 0.01) and increased the number of monthly admissions, 129 versus 142, (p = 0.02). The percentage of patients declined admission because of a closed service line was reduced from 12.36 to 5.66 %, (p = 0.02). Mortality and infection rates remained unchanged.
conclusionsImplementation of mandatory intensivist management in the NCC unit decreased LOS, increased admissions, and decreased service line closure rates, while maintaining patient care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.