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A qualitative exploration of the discharge process and factors predisposing to readmissions to the intensive care unit

Overview of attention for article published in BMC Health Services Research, January 2018
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109 Mendeley
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Title
A qualitative exploration of the discharge process and factors predisposing to readmissions to the intensive care unit
Published in
BMC Health Services Research, January 2018
DOI 10.1186/s12913-017-2821-z
Pubmed ID
Authors

Uchenna R. Ofoma, Yue Dong, Ognjen Gajic, Brian W. Pickering

Abstract

Quantitative studies have demonstrated several factors predictive of readmissions to intensive care. Clinical decision tools, derived from these factors have failed to reduce readmission rates. The purpose of this study was to qualitatively explore the experiences and perceptions of physicians and nurses to gain more insight into intensive care readmissions. Semi-structured interviews of intensive care unit (ICU) and general medicine care providers explored work routines, understanding and perceptions of the discharge process, and readmissions to intensive care. Participants included ten providers from the ICU setting, including nurses (n = 5), consultant intensivists (n = 2), critical care fellows (n = 3) and 9 providers from the general medical setting, nurses (n = 4), consulting physicians (n = 2) and senior resident physicians (n = 3). Principles of grounded theory were used to analyze the interview transcripts. Nine factors within four broad themes were identified: (1) patient factors - severity-of-illness and undefined goals of care; (2) process factors - communication, transitions of care; (3) provider factors - discharge decision-making, provider experience and comfort level; (4) organizational factors - resource constraints, institutional policies. Severe illness predisposes ICU patients to readmission, especially when goals of care were not adequately addressed. Communication, premature discharge, and other factors, mostly unrelated to the patient were also perceived by physicians and nurses to be associated with readmissions to intensive care. Quality improvement efforts that focus on modifying or improving aspects of non-patient factors may improve outcomes for patients at risk of ICU readmission.

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The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 109 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 109 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 17 16%
Student > Bachelor 11 10%
Other 7 6%
Student > Ph. D. Student 7 6%
Student > Doctoral Student 6 6%
Other 14 13%
Unknown 47 43%
Readers by discipline Count As %
Nursing and Health Professions 27 25%
Medicine and Dentistry 19 17%
Social Sciences 5 5%
Engineering 3 3%
Business, Management and Accounting 2 2%
Other 8 7%
Unknown 45 41%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 October 2019.
All research outputs
#7,622,789
of 23,881,329 outputs
Outputs from BMC Health Services Research
#3,763
of 7,949 outputs
Outputs of similar age
#150,362
of 446,418 outputs
Outputs of similar age from BMC Health Services Research
#104
of 172 outputs
Altmetric has tracked 23,881,329 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 7,949 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.0. This one has gotten more attention than average, scoring higher than 51% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 446,418 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.
We're also able to compare this research output to 172 others from the same source and published within six weeks on either side of this one. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.