Organizational factors associated with decreased mortality among veterans affairs patients with an ICU stay

Sales, Anne E., Lapham, Gwendolyn G., Squires, Janet, Hutchinson, Alison, Almenoff, Peter, Sharp, Nancy, Lowy, Elliott and Li, Yu-Fang 2011, Organizational factors associated with decreased mortality among veterans affairs patients with an ICU stay, Computers, informatics, nursing, vol. 29, no. 9, pp. 496-501, doi: 10.1097/NCN.0b013e3182148c47.

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Title Organizational factors associated with decreased mortality among veterans affairs patients with an ICU stay
Author(s) Sales, Anne E.
Lapham, Gwendolyn G.
Squires, Janet
Hutchinson, AlisonORCID iD for Hutchinson, Alison
Almenoff, Peter
Sharp, Nancy
Lowy, Elliott
Li, Yu-Fang
Journal name Computers, informatics, nursing
Volume number 29
Issue number 9
Start page 496
End page 501
Total pages 6
Publisher Lippincott Williams & Wilkins
Place of publication Philadelphia, Pa.
Publication date 2011-09
ISSN 1538-2931
Keyword(s) Electronic record
Hospital organization
In-hospital mortality
Intensive care
Summary In-hospital mortality rates associated with an ICU stay are high and vary widely among units. This variation may be related to organizational factors such as staffing patterns, ICU structure, and care processes. We aimed to identify organizational factors associated with variation in in-hospital mortality for patients with an ICU stay. This was a retrospective observational cross-sectional study using administrative data from 34 093 patients from 171 ICUs in 119 Veterans Health Administration hospitals. Staffing and patient data came from Veterans Health Administration national databases. ICU characteristics came from a survey in 2004 of ICUs within the Veterans Health Administration. We conducted multilevel multivariable estimation with patient-, unit-, and hospital-level data. The primary outcome was in-hospital mortality. Of 34 093 patients, 2141 (6.3%)died in the hospital. At the patient level, risk of complications and having a medical diagnosis were significantly associated with a higher risk of mortality. At the unit level, having an interface with the electronic medical record was significantly associated with a lower risk of mortality. The finding that electronic medical records integrated with ICU information systems are associated with lower in-hospital mortality adds support to existing evidence on organizational characteristics associated with in-hospital mortality among ICU patients.
Language eng
DOI 10.1097/NCN.0b013e3182148c47
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2011, Lippincott Williams & Wilkins, Inc.
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