Impact on 30-d readmissions for cirrhotic patients with ascites after an educational intervention: A pilot study

作     者：Nicholas Lim Otto Sanchez Andrew Olson 

作者机构：Division of GastroenterologyHepatology and NutritionUniversity of MinnesotaMinneapolisMN 55455United States Division of Renal Diseases and HypertensionUniversity of MinnesotaMinneapolisMN 55455United States Division of General Internal MedicineUniversity of MinnesotaMinneapolisMN 55455United States 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2019年第11卷第10期

页      面：701-709页

学科分类：10[医学] 

基　　金：University of Minnesota, UM Institute of Clinical and Translational Sciences, ICTS 

主　　题：Cirrhosis Education Paracentesis Quality 

摘      要：BACKGROUND A low proportion of patients admitted to hospital with cirrhosis receive quality care with timely paracentesis an important target for *** hypothesized that a medical educational intervention,delivered to medical residents caring for patients with cirrhosis,would improve quality of *** To determine if an educational intervention can improve quality of care in cirrhotic patients admitted to hospital with *** We performed a pilot prospective cohort study with time-based randomization over six months at a large teaching *** rotating on hospital medicine teams received an educational intervention while residents rotating on hospital medicine teams on alternate months comprised the control *** primary outcome was provision of quality care-defined as adherence to all quality-based indicators derived from evidence-based practice guidelines-in admissions for patients with cirrhosis and *** clinical outcomesincluding length of hospital stay(LOS);30-d readmission;in-hospital mortality and overall mortality-and resident educational outcomes were also *** Eighty-five admissions(60 unique patients)met inclusion criteria over the study period-46 admissions in the intervention group and 39 admissions in the control ***-seven admissions were female patients,and 44 admissions were for alcoholic liver *** model for end-stage liver disease(MELD)-Na score at admission was ***-seven(55.3%)admissions received quality *** was no difference in the provision of quality care(56.41%vs 54.35%,P=0.9)between the two groups.30-d readmission was lower in the intervention group(35%vs 52.78%,P=0.1)and after correction for age,gender and MELD-Na score[RR=0.62(0.39,1.00),P=0.05].No significant differences were seen for LOS,complications,in-hospital mortality or overall mortality between the two *** medical knowledge and self-efficacy with paracentesis improved after the edu