Providers Consistently Delay Extubation After Successful Spontaneous Breathing Trials: A Retrospective Cohort Study.

Rationale: Many patients who pass a spontaneous breathing trial (SBT) are not extubated, leaving them at risk for life-threatening ventilator-associated complications. Determining barriers to timely extubation may facilitate shorter overall durations of mechanical ventilation.

Objectives: To identify the patient-related and patient-independent barriers to timely extubation within 6 hours of passing an SBT.

Development and Validation of the Hospital Medicine Safety Sepsis Initiative Mortality Model.

Background: When comparing outcomes after sepsis, it is essential to account for patient case mix to make fair comparisons. We developed a model to assess risk-adjusted 30-day mortality in the Michigan Hospital Medicine Safety sepsis initiative (HMS-Sepsis).

Research Question: Can HMS-Sepsis registry data adequately predict risk of 30-day mortality? Do performance assessments using adjusted vs unadjusted data differ?

Study Design And Methods: Retrospective cohort of community-onset sepsis hospitalizations in the HMS-Sepsis registry (April 2022-September 2023), with split derivation (70%) and validation (30%) cohorts.

Heterogeneity of Benefit from Earlier Time-to-Antibiotics for Sepsis.

Shorter time-to-antibiotics improves survival from sepsis, particularly among patients in shock. There may be other subgroups for whom faster antibiotics are particularly beneficial. Identify patient characteristics associated with greater benefit from shorter time-to-antibiotics.

A Multi-Hospital Survey of Current Practices for Supporting Recovery From Sepsis.

Unlabelled: Sepsis survivors are at increased risk for morbidity and functional impairment. There are recommended practices to support recovery after sepsis, but it is unclear how often they are implemented. We sought to assess the current use of recovery-based practices across hospitals.

Interviews with primary care physicians identify unmet transition needs after ICU.

Aim: We sought to explore unmet needs in transitions of care for critical illness survivors that concern primary care physicians.

Findings: Semi-structured interviews with primary care physicians identified three categories of concerns about unmet transition needs after patients' ICU stays: patients' understanding of their ICU stay and potential complications, treatments or support needs not covered by insurance, and starting and maintaining needed rehabilitation and assistance across transitions of care.

Conclusion: Given current constraints of access to coordinated post-ICU care, efforts to identify and address the post-hospitalization needs of critical illness survivors may be improved through coordinated work across the health system.

Hospital Discharge Summaries Are Insufficient Following ICU Stays: A Qualitative Study.

Unlabelled: Primary care providers (PCPs) receive limited information about their patients' ICU stays; we sought to understand what additional information PCPs desire to support patients' recovery following critical illness.

Design: Semistructured interviews with PCPs conducted between September 2020 and April 2021.

Setting: Academic health system with central quaternary-care hospital and associated Veterans Affairs medical center.

Interventions to reduce aggressive care at end of life among patients with cancer: a systematic review.

Little is known about effective interventions to reduce aggressive end-of-life care in patients with cancer. We did a systematic review to assess what interventions are associated with reductions in aggressive end-of-life cancer care. We searched MEDLINE, CINAHL, Embase, Scopus, and PsychINFO for randomised control trials (RCTs), quasi-experimental, and observational studies published before Jan 19, 2018, which aimed to improve measures of aggressive end-of-life care for patients with cancer.