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首页> 外文期刊>BMC Medical Education >Program on high value cost-conscious education in intensive care: Educational program on prediction of outcome and cost awareness on Intensive Care admission
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Program on high value cost-conscious education in intensive care: Educational program on prediction of outcome and cost awareness on Intensive Care admission

机译：重症监护高价值成本意识教育计划：教育计划预测结果和成本意识的重症监护

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Intensive Care (ICU) involves extended and long lasting support of vital functions and organs. However, current training programs of ICU residents mainly focus on extended support of vital functions and barely involve training on cost-awareness and outcome. We incorporated an educational program on high-value cost-conscious care for residents and fellows on our ICU and measured the effect of education. A cohort study with factorial survey design, in which ICU residents and fellows were asked to evaluate clinical vignettes, was performed on the mixed surgical-medical ICU of the Amsterdam University Medical Centre. Residents were offered an educational program focusing on outcome and costs of ICU care. Before and after the program they filled out a questionnaire, which consisted of 23 vignettes, in which known predictors of outcome of community acquired pneumonia (CAP), pancreatitis, acute respiratory distress syndrome (ARDS) and cardiac arrest were presented, together with varying patient factors (age, body mass index (BMI), acute kidney failure (AKI) and haemato-oncological malignancy). Participants were asked to either admit the patient or estimate mortality. BMI, haemato-oncological malignancy and severity of pancreatitis were discriminative for admission to ICU in clinical vignettes on pancreatitis and CAP. After education, only severity of pancreatitis was judged as discriminative. Before the intervention only location of cardiac arrest (in- vs out of hospital) was distinctive for mortality, afterwards this changed to presence of haemato-oncological malignancy. We incorporated an educational program on high-value cost-conscious care in the training of ICU physicians. Based on our vignette study, we conclude that the improvement of knowledge of costs and prognosis after this program was limited.
机译：重症监护（ICU）涉及重要职能和器官的延长和持久的支持。然而，ICU居民的现行培训计划主要关注重要的职能的支持，几乎不涉及对成本意识和结果的培训。我们在我们的ICU上为居民和研究员的高价值成本提供了一个教育计划，并测量了教育的效果。与因子调查设计的队列研究，其中ICU居民和研究员被要求评估临床羽毛，是对阿姆斯特丹大学医疗中心的混合外科医疗ICU进行的。居民提供了一个专注于ICU护理的结果和成本的教育计划。在该计划之前和之后，他们填写了一个调查问卷，该调查问卷由23个鸽子组成，其中提出了患有肺炎（盖子），胰腺炎，急性呼吸窘迫综合征（ARDS）和心脏骤停的结果的已知预测因子，以及不同的患者因素（年龄，体重指数（BMI），急性肾功能衰竭（AKI）和血清肿瘤恶性肿瘤）。要求参与者承认患者或估算死亡率。 BMI，血清肿瘤性恶性肿瘤和胰腺炎的严重程度是在胰腺炎和帽的临床小叶中的ICU入场。教育后，只有胰腺炎的严重程度被判断为歧视。在干预之前，只有心脏骤停的位置（从医院出来）是具有死亡率的独特性，之后这改变了血清肿瘤性恶性肿瘤的存在。我们在ICU医生培训培训方面注册了一个关于高价值成本护理的教育计划。基于我们的小插图研究，我们得出结论，该计划后，提高成本和预后的知识。

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