Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.

PURPOSE:We investigated, using a multicentre survey of practices in France, the practices of ICU physicians concerning the decision not to readmit to the ICU, in light of current legislation. MATERIALS AND METHODS:Multicentre survey of practices among French ICU physicians via electronic questionnai...

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Main Authors: Jean-Philippe Rigaud, Mikhael Giabicani, Nicolas Meunier-Beillard, Fiona Ecarnot, Marion Beuzelin, Antoine Marchalot, Auguste Dargent, Jean-Pierre Quenot
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6193659?pdf=render
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author Jean-Philippe Rigaud
Mikhael Giabicani
Nicolas Meunier-Beillard
Fiona Ecarnot
Marion Beuzelin
Antoine Marchalot
Auguste Dargent
Jean-Pierre Quenot
author_facet Jean-Philippe Rigaud
Mikhael Giabicani
Nicolas Meunier-Beillard
Fiona Ecarnot
Marion Beuzelin
Antoine Marchalot
Auguste Dargent
Jean-Pierre Quenot
author_sort Jean-Philippe Rigaud
collection DOAJ
description PURPOSE:We investigated, using a multicentre survey of practices in France, the practices of ICU physicians concerning the decision not to readmit to the ICU, in light of current legislation. MATERIALS AND METHODS:Multicentre survey of practices among French ICU physicians via electronic questionnaire in January 2016. Questions related to respondents' practices regarding re-admission of patients to the ICU and how these decisions were made. Criteria were evaluated by the health care professionals as regards importance for non-readmission. RESULTS:In total, 167 physicians agreed to participate, of whom 165 (99%) actually returned a completed questionnaire from 58 ICUs. Forty-five percent were aged <35 years, 74% were full-time physicians. The findings show that decisions for non-readmission are taken at the end of the patient's stay (87%), using a collegial decision-making procedure (89% of cases); 93% reported that this decision was noted in the patient's medical file. While 73% indicated that the family/relatives were informed of non-readmission decisions, only 29% reported informing the patient, and 91% considered that non-readmission decisions are an integral part of the French legislative framework. CONCLUSION:This study shows that decisions not to re-admit a patient to the ICU need to be formally materialized, and anticipated by involving the patient and family in the discussions, as well as the other healthcare providers that usually care for the patient. The optimal time to undertake these conversations is likely best decided on a case-by-case basis according to each patient's individual characteristics.
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spelling doaj.art-0828a8e8f29b462e839968d0309b5ac52022-12-22T00:01:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011310e020568910.1371/journal.pone.0205689Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.Jean-Philippe RigaudMikhael GiabicaniNicolas Meunier-BeillardFiona EcarnotMarion BeuzelinAntoine MarchalotAuguste DargentJean-Pierre QuenotPURPOSE:We investigated, using a multicentre survey of practices in France, the practices of ICU physicians concerning the decision not to readmit to the ICU, in light of current legislation. MATERIALS AND METHODS:Multicentre survey of practices among French ICU physicians via electronic questionnaire in January 2016. Questions related to respondents' practices regarding re-admission of patients to the ICU and how these decisions were made. Criteria were evaluated by the health care professionals as regards importance for non-readmission. RESULTS:In total, 167 physicians agreed to participate, of whom 165 (99%) actually returned a completed questionnaire from 58 ICUs. Forty-five percent were aged <35 years, 74% were full-time physicians. The findings show that decisions for non-readmission are taken at the end of the patient's stay (87%), using a collegial decision-making procedure (89% of cases); 93% reported that this decision was noted in the patient's medical file. While 73% indicated that the family/relatives were informed of non-readmission decisions, only 29% reported informing the patient, and 91% considered that non-readmission decisions are an integral part of the French legislative framework. CONCLUSION:This study shows that decisions not to re-admit a patient to the ICU need to be formally materialized, and anticipated by involving the patient and family in the discussions, as well as the other healthcare providers that usually care for the patient. The optimal time to undertake these conversations is likely best decided on a case-by-case basis according to each patient's individual characteristics.http://europepmc.org/articles/PMC6193659?pdf=render
spellingShingle Jean-Philippe Rigaud
Mikhael Giabicani
Nicolas Meunier-Beillard
Fiona Ecarnot
Marion Beuzelin
Antoine Marchalot
Auguste Dargent
Jean-Pierre Quenot
Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.
PLoS ONE
title Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.
title_full Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.
title_fullStr Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.
title_full_unstemmed Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.
title_short Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.
title_sort non readmission decisions in the intensive care unit under french rules a nationwide survey of practices
url http://europepmc.org/articles/PMC6193659?pdf=render
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