Dept Internal Medicine, Catharina Hospital Eindhoven, Eindhoven, Netherlands.
Dept of Intensive Care, Catharina Hospital Eindhoven, Eindhoven, Netherlands.
PLoS One. 2022 Aug 23;17(8):e0273197. doi: 10.1371/journal.pone.0273197. eCollection 2022.
In a time of worldwide physician shortages, the advanced practice providers (APPs) might be a good alternative for physicians as the leaders of a rapid response team. This retrospective analysis aimed to establish whether the performance of APP-led rapid response teams is comparable to the performance of rapid response teams led by a medical resident of the ICU.
In a retrospective single-center cohort study, the electronic medical record of a tertiary hospital was queried during a 12-months period to identify patients who had been visited by our rapid response team. Patient- and process-related outcomes of interventions of rapid response teams led by an APP were compared with those of teams led by a medical resident using various parameters, including the MAELOR tool, which measures the performance of a rapid response team.
In total, 179 responses of the APP-led teams were analyzed, versus 275 responses of the teams led by a resident. Per APP, twice as many calls were handled than per resident. Interventions of teams led by APPs, and residents did not differ in number of admissions (p = 0.87), mortality (p = 0.8), early warning scores (p = 0.2) or MAELOR tool triggering (p = 0.19). Both groups scored equally on time to admission (p = 0.67) or time until any performed intervention.
This retrospective analysis showed that the quality of APP-led rapid response teams was similar to the quality of teams led by a resident. These findings need to be confirmed by prospective studies with balanced outcome parameters.
在全球医生短缺的情况下,高级实践提供者 (APP) 可能是替代医生作为快速反应团队领导者的良好选择。本回顾性分析旨在确定 APP 领导的快速反应团队的表现是否与 ICU 住院医师领导的快速反应团队的表现相当。
在一项回顾性单中心队列研究中,对一家三级医院的电子病历进行了为期 12 个月的查询,以确定接受我们快速反应团队就诊的患者。使用各种参数(包括测量快速反应团队表现的 MAELOR 工具)比较了由 APP 领导的快速反应团队与由住院医师领导的团队的干预措施的患者和过程相关结果。
共分析了 179 次 APP 领导团队的响应,而由住院医师领导的团队响应了 275 次。与每个住院医师相比,每个 APP 处理的电话次数是其两倍。由 APP 领导的团队和住院医师的干预措施在入院人数(p = 0.87)、死亡率(p = 0.8)、预警评分(p = 0.2)或 MAELOR 工具触发(p = 0.19)方面没有差异。两组在入院时间(p = 0.67)或任何干预措施执行前的时间方面得分相同。
这项回顾性分析表明,APP 领导的快速反应团队的质量与住院医师领导的团队的质量相似。这些发现需要通过具有平衡结果参数的前瞻性研究来证实。