Quantitative analysis of the impact of infectious disease physicians on patients in the emergency department fast-track parenteral antibiotics program.

Autor: McSweeney C; Jim Pattison Pavilion, 899 W 12th Ave, V5Z 1M9, Vancouver, BC, Canada. cmcsween@student.ubc.ca.; Resident Physician University of British Columbia, Vancouver General Hospital, 596 Davis Drive, L3Y 2P9, Vancouver, Newmarket, BC, Ontario, Canada. cmcsween@student.ubc.ca., Steiner T; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada. tsteiner@mail.ubc.ca., Grant JM; Division of Infectious Diseases, Division of Medical Microbiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada. jennifer.Grant@vch.ca.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Jul 01; Vol. 24 (1), pp. 655. Date of Electronic Publication: 2024 Jul 01.
DOI: 10.1186/s12879-024-09305-0
Abstrakt: Introduction: The outpatient parenteral antibiotic therapy (OPAT) program of Vancouver General Hospital (VGH) was supervised by emergency physicians (EPs) until 2017 when infectious disease (ID) physicians began assisting in management. We designed a retrospective study to determine whether ID involvement led to improved outcomes.
Methods: This study analyzes the impact of ID involvement by comparing the mean days patients spent on OPAT with ID involvement versus EPs alone through a retrospective chart review. Secondary research objectives were to compare patient care decisions, e.g., antibiotic choice, tests ordered, and final diagnosis.
Results: There was no difference between the mean number of days on OPAT between physician types. Compared to historic patterns, patients seen in OPAT after increased ID consultation spent an average of 0.5 fewer days in the program. However, when grouped by the first day of ID assessment, the average total days in OPAT was closely aligned with the day of first ID assessment, implying that ID frequently discharged patients close to initial assessment. Patients seen by ID were less likely to return within one month of discharge compared to those not seen by ID. Secondary findings include ID physicians prescribing a greater range of antibiotics, providing more varied final diagnoses, prescribing antibiotics less frequently, as well as ordering more cultures, diagnostic imaging and specialist consults.
Discussion: The findings of this study support the hypothesis that ID involvement in OPAT programs leads to changes in care that may have beneficial outcomes for patients and the healthcare system.
(© 2024. The Author(s).)
Databáze: MEDLINE
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