Anesthesiologists as perioperative hospitalists and outcomes in patients undergoing major urologic surgery: a historical prospective, comparative effectiveness study

Autor: Gary Stier, Davinder Ramsingh, Ronak Raval, Gary Shih, Bryan Halverson, Briahnna Austin, Joseph Soo, Herbert Ruckle, Robert Martin
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Perioperative Medicine, Vol 7, Iss 1, Pp 1-11 (2018)
Druh dokumentu: article
ISSN: 2047-0525
DOI: 10.1186/s13741-018-0090-y
Popis: Abstract Background Perioperative care has been identified as an area of wide variability in quality, with conflicting models, and involving multiple specialties. In 2014, the Loma Linda University Departments of Anesthesiology and Urology implemented a perioperative hospitalist service (PHS), consisting of anesthesiology-trained physicians, to co-manage patients for the entirety of their perioperative period. We hypothesized that implementation of this PHS model would result in an improvement in patient recovery. Methods As a quality improvement (QI) initiative, the PHS service was formed of selected anesthesiologists who received training on the core competencies for hospitalist medicine. The service was implemented following a co-management agreement to medically manage patients undergoing major urologic procedures (prostatectomy, cystectomy, and nephrectomy). Impact was assessed by comparisons to data from the year prior to PHS service implementation. Data was compared with and without propensity matching. Primary outcome marker was a reduction in length of stay. Secondary outcome markers included complication rate, return of bowel function, number of consultations, reduction in total direct patient costs, and bed days saved. Results Significant reductions in length of stay (p
Databáze: Directory of Open Access Journals
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