Changing the Care Paradigm for Patients: Advanced Illness Beds Care Model.
| Autor: | Rimar A; Department of Medicine, Geriatrics and Palliative Care, 5945Lenox Hill Hospital, New York, NY, USA., Friedman MI; Clinical Transformation, 5799Northwell Health, New Hyde Park, NY, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA., Quinteros MG; Department of Medicine, Geriatrics and Palliative Care, 25049Long Island Jewish Medical Center, Northwell Health, New Hyde Park, NY, USA., Gooch RA; Clinical Transformation, 5799Northwell Health, New Hyde Park, NY, USA., Masick KD; Krasnoff Quality Management Institute, 5799Northwell Health, New Hyde Park, NY, USA.; Hofstra University, Hempstead, NY, USA., DaCosta N; Clinical Transformation, 5799Northwell Health, New Hyde Park, NY, USA., Spooner RL; Clinical Transformation, 5799Northwell Health, New Hyde Park, NY, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2021 Nov; Vol. 38 (11), pp. 1336-1341. Date of Electronic Publication: 2020 Dec 24. |
| DOI: | 10.1177/1049909120984384 |
| Abstrakt: | Background: Over 90 million Americans suffer from advanced illness (AI) and spend their last days of life in critical care units receiving costly, unwanted, aggressive medical care. Objective: Evaluate the impact of a specialized care model in medical/surgical units for hospitalized geriatric patients and patients with complex care requirements where designated AI beds align care with patient's wishes/goals, minimize aggressive interventions, and influence efficient resource utilization. Design: US based multi-facility retrospective, longitudinal descriptive study of screened positive AI patients in AI Beds (N = 1,237) from 3 facilities from 2015 to 2017. Results: Patient outcomes included 60% referrals to AI beds from ICU, a decrease of 39-49% in average ICU LOS, a 23% reduction of AI bed patient expirations, 9.0% referrals to hospice, and projected cost savings of $4,361.66/patient, US dollars. Conclusion: Allocating AI beds to deliver care to AI patients resulted in a decreased cost of care by reducing overall hospital LOS, mortality, and efficient use of both critical care and hospital resources. |
| Databáze: | MEDLINE |
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