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Variability in Mean Duration of Mechanical Ventilation among Community Hospitals

Published online by Cambridge University Press:  02 January 2015

Michael Klompas*
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts Infection Control Department, Brigham and Women's Hospital, Boston, Massachusetts
Ken P. Kleinman
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Anita Karcz
Affiliation:
Institute for Health Metrics, Burlington, Massachusetts
*
Michael Klompas, MD, MPH, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 (mklompas@partners.org)

Abstract

We explored intensive care units' mean ventilator-days per patient as a possible objective alternative to ventilator-associated pneumonia rates for assessing quality of care for ventilated Patients. Mean ventilator-days per patient varied 4-fold within a network of community hospitals despite adjusting for multiple patient and hospital factors. Further assessment of this metric is warranted.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

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References

1. Klompas, M, Platt, R. Ventilator-associated pneumonia-the wrong quality measure for benchmarking. Ann Intern Med 2007; 147(11):803805.Google Scholar
2. Klompas, M. Interobserver variability in ventilator-associated pneumonia surveillance. Am J Infect Cont 2010;38(3):237239.Google Scholar
3. Klompas, M, Kulldorff, M, Platt, R. Risk of misleading ventilator-associated pneumonia rates with use of standard clinical and microbiological criteria. Clin Infect Dis 2008;46(9):14431446.Google Scholar
4. Klompas, M. Unintended consequences in the drive for zero. Thorax 2009;64(6):463465.Google Scholar
5. Klompas, M. Eight initiatives that misleadingly lower ventilator-associated pneumonia rates. Am J Infect Cont. Forthcoming, doi: 10.1016/j.ajic.2011.07.012.Google Scholar
6. Uckay, I, Ahmed, QA, Sax, H, Pittet, D. Ventilator-associated pneumonia as a quality indicator for patient safety? Clin Infect Dis 2008;46(4):557563.Google Scholar
7. Jackson, DL, Proudfoot, CW, Cann, KF, Walsh, T. A systematic review of the impact of sedation practice in the ICU on resource use, costs and patient safety. Crit Care 2010;14(2):R59.Google Scholar
8. Schweickert, WD, Gehlbach, BK, Pohlman, AS, Hall, JB, Kress, JP. Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med 2004;32(6):12721276.Google Scholar
9. Girard, TD, Kress, JP, Fuchs, BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008;371(9607):126134.Google Scholar
10. Strom, T, Martinussen, T, Toft, P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 2010;375(9713):475480.Google Scholar
11. Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000;342(18):13011308.Google Scholar