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Information sharing between intensive care and primary care after an episode of critical illness; A mixed methods analysis.
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- المؤلفون: Zilahi G;Zilahi G; O'Connor E; O'Connor E; O'Connor E
- المصدر:
PloS one [PLoS One] 2019 Feb 28; Vol. 14 (2), pp. e0212438. Date of Electronic Publication: 2019 Feb 28 (Print Publication: 2019).
- نوع النشر :
Journal Article; Observational Study; Research Support, Non-U.S. Gov't
- اللغة:
English
- معلومة اضافية
- المصدر:
Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
- بيانات النشر:
Original Publication: San Francisco, CA : Public Library of Science
- الموضوع:
- نبذة مختصرة :
Introduction: Poor quality communication between hospital doctors and GPs at the time of hospital discharge is associated with adverse patient outcomes. This may be more marked after an episode of critical illness, the complications of which can persist long after hospital discharge.
Aims: 1. to evaluate information sharing between ICU staff and GPs after a critical illness 2. to identify factors influencing the flow and utilisation of this information.
Methods: Parallel mixed methods observational study in an Irish setting, with equal emphasis on quantitative and qualitative data. Descriptive analysis was performed on quantitative data derived from GP and ICU consultant questionnaires. Qualitative data came from semi-structured interviews with GPs and consultants, and were analysed using directed content analysis. Mixing of data occurred at the stage of interpretation.
Results: GPs rarely received information about an episode of critical illness directly from ICU staff, with most coming from patients and relatives. Information received from hospital sources was frequently brief and incomplete. Common communication barriers reported by consultants were insufficient time, low perceived importance and difficulty establishing GP contact. When provided information, GPs seldom actioned specific interventions, citing insufficient guidance in hospital correspondence and poor knowledge about critical illness complications and their management. A majority of all respondents thought that improved information sharing would benefit patients. Cultural influences on practice were identified in qualitative data. A priori qualitative themes were: (1) perceived benefits of information sharing, (2) factors influencing current practice and (3) strategies for optimal information sharing. Emergent themes were: (4) the central role of the GP in patient care, (5) the concept of the "whole patient journey" and (6) a culture of expectation around a GP's knowledge of hospital care.
Conclusions: Practical and cultural factors contribute to suboptimal information sharing between ICU and primary care doctors around an episode of critical illness in ICU. We propose a three-milestone strategy to improve the flow and utilisation of information when patients are admitted, discharged or die within the ICU.
Competing Interests: The authors have declared that no competing interests exist.
- References:
Qual Health Res. 2005 Nov;15(9):1277-88. (PMID: 16204405)
JAMA Intern Med. 2018 Oct 1;178(10):1390-1399. (PMID: 30128550)
JAMA. 2014 Mar 19;311(11):1133-42. (PMID: 24643603)
J Crit Care. 2015 Apr;30(2):242-9. (PMID: 25466314)
Am J Crit Care. 2015 Nov;24(6):496-500. (PMID: 26523007)
N Engl J Med. 2011 Apr 7;364(14):1293-304. (PMID: 21470008)
Crit Care Med. 2015 Feb;43(2):430-8. (PMID: 25599467)
BMJ Open. 2014 May 15;4(5):e004963. (PMID: 24833691)
BMJ Qual Saf. 2012 Dec;21 Suppl 1:i1-6. (PMID: 23173180)
JAMA. 2017 Feb 7;317(5):530-531. (PMID: 28114505)
Qual Health Res. 2016 Nov;26(13):1753-1760. (PMID: 26613970)
Br J Gen Pract. 2016 Dec;66(653):e904-e912. (PMID: 27872086)
JAMA. 2010 Oct 27;304(16):1787-94. (PMID: 20978258)
Ann Am Thorac Soc. 2016 Sep;13(9):1538-45. (PMID: 27333269)
Intensive Care Med. 2015 Apr;41(4):589-604. (PMID: 25672275)
J Gen Intern Med. 2003 Aug;18(8):646-51. (PMID: 12911647)
BMJ Qual Saf. 2012 Dec;21 Suppl 1:i58-66. (PMID: 23100546)
Crit Care. 2013 May 28;17(3):R100. (PMID: 23714692)
Crit Care. 2010;14(3):R112. (PMID: 20546560)
Curr Opin Crit Care. 2006 Dec;12(6):604-8. (PMID: 17077695)
Crit Care Med. 2008 May;36(5):1523-30. (PMID: 18434893)
Intensive Care Med. 2016 May;42(5):725-738. (PMID: 27025938)
BMJ. 2000 Jan 1;320(7226):50-2. (PMID: 10617534)
JAMA. 2007 Feb 28;297(8):831-41. (PMID: 17327525)
Br J Gen Pract. 2015 Dec;65(641):e829-37. (PMID: 26622036)
BMC Health Serv Res. 2017 Apr 4;17(1):251. (PMID: 28376872)
JAMA. 2010 Mar 3;303(9):849-56. (PMID: 20197531)
Nurs Res. 1991 Mar-Apr;40(2):120-3. (PMID: 2003072)
Nurs Crit Care. 2018 Nov;23(6):316-323. (PMID: 28640509)
Ann Intern Med. 2010 Feb 16;152(4):247-58. (PMID: 20157139)
Health Serv Res. 2013 Dec;48(6 Pt 2):2134-56. (PMID: 24279835)
- الموضوع:
Date Created: 20190301 Date Completed: 20191206 Latest Revision: 20200309
- الموضوع:
20221213
- الرقم المعرف:
PMC6394993
- الرقم المعرف:
10.1371/journal.pone.0212438
- الرقم المعرف:
30818372
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