Program on high value cost-conscious education in intensive care: Educational program on prediction of outcome and cost awareness on Intensive Care admission
| Autor: | Charlotte J. P. Beurskens, L. van Wagenberg, M. C. A. Müller, I. Stegeman |
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| Přispěvatelé: | Epidemiology and Data Science, Intensive Care Medicine, Other Research, ACS - Pulmonary hypertension & thrombosis |
| Rok vydání: | 2020 |
| Předmět: |
ARDS
medicine.medical_specialty Critical Care Clinical Decision-Making lcsh:Medicine Education Cohort Studies Post-graduate education 03 medical and health sciences 0302 clinical medicine Community-acquired pneumonia Surveys and Questionnaires Intensive care medicine Humans High-value cost-conscious care Curriculum development 030212 general & internal medicine Evaluation of education lcsh:LC8-6691 Medical education lcsh:Special aspects of education business.industry lcsh:R Internship and Residency 030208 emergency & critical care medicine General Medicine medicine.disease Intensive Care Units Vignette Education Medical Graduate Emergency medicine Pancreatitis business Body mass index Educational program Program Evaluation Research Article Cohort study |
| Zdroj: | BMC Medical Education, Vol 20, Iss 1, Pp 1-8 (2020) BMC medical education, 20(1):186. BioMed Central BMC Medical Education |
| ISSN: | 1472-6920 |
| DOI: | 10.1186/s12909-020-02100-w |
| Popis: | Background Intensive Care (ICU) involves extended and long lasting support of vital functions and organs. However, current training programs of ICU residents mainly focus on extended support of vital functions and barely involve training on cost-awareness and outcome. We incorporated an educational program on high-value cost-conscious care for residents and fellows on our ICU and measured the effect of education. Methods A cohort study with factorial survey design, in which ICU residents and fellows were asked to evaluate clinical vignettes, was performed on the mixed surgical-medical ICU of the Amsterdam University Medical Centre. Residents were offered an educational program focusing on outcome and costs of ICU care. Before and after the program they filled out a questionnaire, which consisted of 23 vignettes, in which known predictors of outcome of community acquired pneumonia (CAP), pancreatitis, acute respiratory distress syndrome (ARDS) and cardiac arrest were presented, together with varying patient factors (age, body mass index (BMI), acute kidney failure (AKI) and haemato-oncological malignancy). Participants were asked to either admit the patient or estimate mortality. Results BMI, haemato-oncological malignancy and severity of pancreatitis were discriminative for admission to ICU in clinical vignettes on pancreatitis and CAP. After education, only severity of pancreatitis was judged as discriminative. Before the intervention only location of cardiac arrest (in- vs out of hospital) was distinctive for mortality, afterwards this changed to presence of haemato-oncological malignancy. Conclusion We incorporated an educational program on high-value cost-conscious care in the training of ICU physicians. Based on our vignette study, we conclude that the improvement of knowledge of costs and prognosis after this program was limited. |
| Databáze: | OpenAIRE |
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