Keeping abreast of the changes in evidence is crucial in delivering quality patient care. This seems like a no-brainer, but still it is a lesson that is learnt again and again. And really, as a medical information professional, a key reason why we exist.
Has anyone had a chance to look at the following article (full citation and abstract below)?
"Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice."
In the article, the authors examine quality of care in an urban hospital for patients, measuring patient outcome indicators such as length of stay and patient mortality rates and compared the results with the independent variable of number of years in practice. The results? As the title indicates, patients who are treated by physicians with more years in practice stay progressively longer in hospital. And there is an increased mortality rate in patients treated by those with 20+ years experience.
What does this mean? While experience is crucial, incorporating evidence into practice is essential.
How do you keep abreast of current evidence? Are you using any alert services to provide you with the information you need? And most importantly, where are you looking for Patient Safety alerts?
I've put some links to Patient Safety websites that are useful in my delicious account: http://www.delicious.com/kathryn.ranjit/patient_safety. If there are any others you are checking out, please comment below or create a post about your favourite Patient Safety awareness site.
Article citation and abstract:
Abstract
BACKGROUND: More physician years in practice have been associated with less frequent guideline adherence, but it is unknown whether years in practice are associated with patient outcomes.
METHODS: We examined all inpatients on the teaching service of an urban hospital from July 1, 2002 through June 30, 2004. Admissions were assigned to attending physicians quasi-randomly. Years in practice was defined as the number of years the attending physician held a medical license. We divided physicians into 4 groups (0-5, 6-10, 11-20, and 20 years in practice), and used negative binomial and logistic regression to adjust for patient characteristics and estimate associations between years in practice and length-of-stay, readmission, and mortality.
RESULTS: Fifty-nine physicians and 6572 admissions were examined. Although the 4 inpatient groups had similar demographic and clinical characteristics, physicians with more years in practice had longer mean lengths of stay (4.77, 5.29, 5.42, and 5.31 days for physicians with 0-5, 6-10, 11-20, and 20 years in practice, respectively, P .001). After adjustment, inpatients of physicians with more than 20 years in practice had higher risk for both in-hospital mortality (odds ratio 1.71; 95% confidence interval, 1.06-2.76) and 30-day mortality (odds ratio 1.51, 95% confidence interval, 1.06-2.16) than inpatients of physicians with 0-5 years in practice.
CONCLUSION: Inpatient care by physicians with more years in practice is associated with higher risk of mortality. Quality-of-care interventions should be developed to maintain inpatient skills for physicians
This article is available through document delivery at the U of C. If you are interested in getting a full text copy, simply copy and paste the citation into an email to plcinfo@ucalgary.ca or tbccinfo@ucalgary.ca.
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