Using simulation to isolate physician variation in intensive care unit admission decision making for critically ill elders with end-stage cancer: A pilot feasibility study

Critical Care Medicine

Volumn 36, Issue 12, 2008, Pages 3156-3163

  Barnato, Amber E ^a   Hsu, Heather E ^b   Bryce, Cindy L ^a   Lave, Judith R ^c   Emlet, Lillian L ^d   Angus, Derek C ^a   Arnold, Robert M ^a,e  

^a UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^b HARVARD UNIVERSITY   (United States)

^c UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH   (United States)

^d UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

^e Division of General Internal Medicine

Author keywords

Cancer; Intensive care; Physician decision making; Simulation; Terminal care

Indexed keywords

ADVANCED CANCER; ATTITUDE; CANCER GROWTH; CANCER PATIENT; CLINICAL ASSESSMENT; CODING; CRITICALLY ILL PATIENT; DEMOGRAPHY; DIAGNOSTIC TEST; EMERGENCY HEALTH SERVICE; EMERGENCY PHYSICIAN; FEASIBILITY STUDY; GERIATRIC PATIENT; HEALTH SURVEY; HOSPITAL ADMISSION; HUMAN; HYPOXIA; INTENSIVE CARE UNIT; INTERVIEW; INTUBATION; MEDICAL DECISION MAKING; MEDICAL INFORMATION; MEDICAL PRACTICE; MEDICAL RECORD REVIEW; MEDICAL SCHOOL; METASTASIS; PALLIATIVE THERAPY; PRIORITY JOURNAL; PROGNOSIS; QUALITATIVE ANALYSIS; QUANTITATIVE ANALYSIS; REVIEW; SIMULATION; STOMACH CANCER; TERMINAL DISEASE; VITAL SIGN; ADULT; AGED; ARTICLE; CLINICAL PRACTICE; CRITICAL ILLNESS; FEMALE; HEALTH PERSONNEL ATTITUDE; LIVING WILL; MALE; MIDDLE AGED; NEOPLASM; PILOT STUDY; RISK ASSESSMENT; TEACHING; TERMINAL CARE; TIME;

ADULT; ADVANCE DIRECTIVES; AGED; ATTITUDE OF HEALTH PERSONNEL; CRITICAL ILLNESS; DEMOGRAPHY; FEASIBILITY STUDIES; FEMALE; HUMANS; INTENSIVE CARE UNITS; MALE; MIDDLE AGED; NEOPLASMS; PALLIATIVE CARE; PATIENT ADMISSION; PATIENT SIMULATION; PHYSICIAN'S PRACTICE PATTERNS; PILOT PROJECTS; RISK ASSESSMENT; TERMINAL CARE; TIME FACTORS;

EID: 58149232944     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e31818f40d2     Document Type: Article

References (39)

1. Angus DC, Barnato AE, Linde-Zwirble WT, et al: Use of intensive care at the end of life in the United States: An epidemiologic study. Crit Care Med 2004; 32:638-643
2. Guidelines for intensive care unit admission, discharge, and triage. Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med 1999; 27:633-638
3. Azoulay E, Pochard F, Chevret S, et al: Compliance with triage to intensive care recommendations. Crit Care Med 2001; 29: 2132-2136
4. Azoulay E, Afessa B: The intensive care support of patients with malignancy: Do everything that can be done. Intensive Care Med 2006; 32:3-5
5. Strauss MJ, LoGerfo JP, Yeltatzie JA, et al: Rationing of intensive care unit services. An everyday occurrence. JAMA 1986; 255: 1143-1146
6. Singer DE, Carr PL, Mulley AG, et al: Rationing intensive care-physician responses to a resource shortage. N Engl J Med 1983; 309: 1155-1160
7. Sinuff T, Kahnamoui K, Cook DJ, et al: Rationing critical care beds: a systematic review. Crit Care Med 2004; 32:1588-1597
8. Smith WR, Poses RM, McClish DK, et al: Prognostic judgments and triage decisions for patients with acute congestive heart failure. Chest 2002; 121:1610-1617
9. Zussman R: Intensive Care: Medical Ethics and the Medical Profession. Chicago, IL, University of Chicago Press, 1992
10. Cassell J: Life and Death in Intensive Care. Philadelphia, PA, Temple University Press, 2005
11. Kaufman SR: And a Time to Die: How American Hospitals Shape the End of Life. New York, Scribner, 2005
12. Christakis NA: Death Foretold: Prophecy and Prognosis in Medical Care. Chicago, IL, The University of Chicago Press, 1999
13. McDonagh JR, Elliott TB, Engelberg RA, et al: Family satisfaction with family conferences about end-of-life care in the intensive care unit: Increased proportion of family speech is associated with increased satisfaction. Crit Care Med 2004; 32:1484-1488
14. Cook D, Rocker G, Marshall J, et al: Withdrawal of mechanical ventilation in anticipation of death in the intensive care unit. N Engl J Med 2003; 349:1123-1132
15. Sprung CL, Geber D, Eidelman LA, et al: Evaluation of triage decisions for intensive care admission. Crit Care Med 1999; 27: 1073-1079
16. Joynt GM, Gomersall CD, Tan P, et al: Prospective evaluation of patients refused admission to an intensive care unit: Triage, futility and outcome. Intensive Care Med 2001; 27: 1459-1465
17. Garrouste-Orgeas M, Montuclard L, Timsit JF, et al: Predictors of intensive care unit refusal in French intensive care units: A multiple-center study. Crit Care Med 2005; 33: 750-755
18. Boyle DK, Miller PA, Forbes-Thompson SA: Communication and end-of-life care in the intensive care unit: Patient, family, and clinician outcomes. Crit Care Nurs Q 2005; 28:302-316
19. Proceedings of the AAMC'S Consensus Conference on the Use of Standardized Patients in the Teaching and Evaluation of Clinical Skills. Washington, D.C., December 3-4, 1992. Acad Med 1993, 68(6):437-483
20. Weller JM: Simulation in undergraduate medical education: Bridging the gap between theory and practice. Med Educ 2004; 38: 32-38
21. Nightingale SD, Grant M: Risk preference and decision making in critical care situations. Chest 1988; 93:684-687
22. Poses RM, De Saintonge DM, McClish DK, et al: An international comparison of physicians' judgments of outcome rates of cardiac procedures and attitudes toward risk, uncertainty, justifiability, and regret. Med Decis Making 1998; 18:131-140
23. Gerrity MS, White KD, DeVellis RF, et al: Physician's reactions to uncertainty: Refining the constructs and scales. Motiv Emot 1995; 19:175-191
24. Gerrity MS, DeVellis RF, Earp JA: Physicians' reactions to uncertainty in patient care. A new measure and new insights. Med Care 1990; 28:724-736
25. Bradley P: The history of simulation in medical education and possible future directions. Med Educ 2006; 40:254-262
26. Ericsson KA: Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004; 79(suppl 10):S70-S81
27. Fritz PZ, Gray T, Flanagan B: Review of mannequin-based high-fidelity simulation in emergency medicine. Emerg Med Australas 2008; 20:1-9.
28. Issenberg SB, McGaghie WC, Petrusa ER, et al: Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Med Teach 2005; 27:10-28
29. Kneebone R: Evaluating clinical simulations for learning procedural skills: A theory-based approach. Acad Med 2005; 80:549-553
30. Sirovich BE, Gottlieb DJ, Welch HG, et al: Variation in the tendency of primary care physicians to intervene. Arch Intern Med 2005; 165:2252-2256
31. Winslow C, Kosecoff J, Chassin M, et al: The appropriateness of performing coronary artery bypass surgery. JAMA 1988; 260: 505-509
32. Schulman KA, Berlin JA, Harless W, et al: The effect of race and sex on physicians' recommendations for cardiac catheterization [see comments] [erratum appears in N Engl J Med 1999; 340:1130]. N Engl J Med 1999; 340:618-626
33. Christakis NA, Asch DA: Physician characteristics associated with decisions to withdraw life support. Am J Public Health 1995; 85: 367-372
34. Hanson LC, Danis M, Garrett JM, et al: Who decides? Physicians' willingness to use life-sustaining treatment. Arch Intern Med 1996; 156:785-789
35. Kelly WF, Eliasson AH, Stocker DJ, et al: Do specialists differ on do-not-resuscitate decisions? Chest 2002; 121:957-963
36. Swanson JW, McCrary SV: Doing all they can: Physicians who deny medical futility. J Law Med Ethics 1994; 22:318-326
37. Wenger NS, Carmel S: Physicians' religiosity and end-of-life care attitudes and behaviors. Mt Sinai J Med 2004; 71:335-343
38. Anonymous: A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). JAMA 1995; 274: 1591-1598
39. Garland A, Shaman Z, Baron J, et al: Physician-attributable differences in intensive care unit costs: A single-center study. Am J Respir Crit Care Med 2006; 174:1206-1210