Original Articles
Vol. 15 No. 1 (2021)
https://doi.org/10.4081/itjm.2021.1447

Not-for-profit observational study to evaluate the quality and safety of care in outliers hospitalized with medical diseases - Study Protocol of Safety Issues and SurvIval For Medical Outliers (SISIFO study)

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 18 March 2021
1506
Views
754
Downloads
18
HTML
Outliers, Internal Medicine, quality and safety of care.

Authors

Micaela La Regina
micaela.laregina@asl5.liguria.it
https://orcid.org/0000-0002-9303-4757
SS Risk Management, ASL5 Liguria, La Spezia, Italy.
Chiara Vertulli
https://orcid.org/0000-0003-3321-5414
FADOI Foundation, Milano, Italy.
Gualberto Gussoni
https://orcid.org/0000-0003-3573-5069
FADOI Foundation, Milano, Italy.
Andrea Fontanella
Internal Medicine, Buonconsiglio Fatebenefratelli Hospital, Napoli, Italy.
Giorgio Ballardini
Internal Medicine 2, Infermi Hospital, Rimini, Italy.
Antonio Brucato
https://orcid.org/0000-0002-7566-5600
Department of Biomedical and Clinical Sciences, Fatebenefratelli Hospital, Milano, Italy.
Francesco Orlandini
Direzione Sanitaria, ASL4 Liguria, Chiavari (GE), Italy.
Giovanni Murialdo
Department of Internal Medicine and Medical Specialties, IRCCS San Martino, Genova, Italy.
Mauro Campanini
Department of Internal Medicine, Maggiore della Carità Hospital, Novara, Italy.
Dario Manfellotto
https://orcid.org/0000-0003-2071-277X
Department of Internal Medicine, Fatebenefratelli Isola Tiberina Hospital, Roma, Italy.

The progressive cutting of hospital beds in some health systems, together with the increased needs related to the aging population, has led to the phenomenon of patients hospitalized outside the appropriate ward (outliers). This is particularly relevant in the context of Internal Medicine. Despite its relevance in daily clinical practice, available evidence for the potential impact of this phenomenon is limited. The aim of this study is to evaluate the effects of this situation on patients' outcomes and possibly identify organizational and managerial aspects related to the presence of outliers. The multicenter, observational, prospective Study Protocol of Safety Issues and SurvIval For Medical Outliers (SISIFO) was promoted by the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI). The primary study endpoint is the evaluation of in-hospital mortality in outliers versus controls. A sample size of 2400 patients has been estimated by assuming a mortality rate of 12% and 8% in outliers and controls, respectively. By virtue of the multicentric dimension, the expected number of patients, and the controlled design, the FADOI-SISIFO study might provide interesting and useful findings to better manage the phenomenon of outliers.

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Stylianou N, Fackrell R, Vasilakis C. Are medical outliers associated with worse patient outcomes? A retrospective study within a regional NHS hospital using routine data. MJ Open 2017;7:e015676.
Goulding L, Adamson J, Watt I, et al. Lost in hospital: a qualitative interview study that explores the perceptions of NHS inpatients who spent time on clinically inappropriate hospital wards. Health Expect 2015;18:982-94.
Goulding L, Adamson J, Watt I, et al. Patient safety in patients who occupy beds on clinically inappropriate wards: a qualitative interview study with NHS staff. BMJ Qual Saf 2012;21:218-24.
Perimal-Lewis L, Li JY, Hakendorf PH, et al. Relationship between in-hospital location and outcomes of care in patients of a large general medical service. Intern Med J 2013;43:712-6.
Santamaria JD, Tobin AE, Anstey MH, et al. Do outlier inpatients experience more emergency calls in hospital? An observational cohort study. Med J Aust 2014;200:45-8.
Perimal-Lewis L, Bradley C, Hakendorf PH, et al. The relationship between in-hospital location and outcomes of care in patients diagnosed with dementia and/or delirium diagnoses: analysis of patient journey. BMC Geriatr 2016;16:190.
Stowell A, Claret PG, Sebbane M, et al. Hospital out-lying through lack of beds and its impact on care and patient outcome. Scand J Trauma Resusc Emerg Med 2013;21:17.
Alameda C, Suárez C. Clinical outcomes in medical outliers admitted to hospital with heart failure. Eur J Intern Med 2009;20:764-7.
Serafini F, Fantin G, Brugiolo R, et al. Outlier admissions of medical patients: prognostic implications of outlying patients. the experience of the hospital of Mestre. Ital J Med 2015;9:299-302.
Woodford H, Walker R. Emergency hospital admissions in idiopathic Parkinson’s disease. Movement Disord 2005;20:1104-8.
Creamer GL, Dahl A, Perumal D, et al. Anatomy of the ward round: the time spent in different activities. ANZ J Surg 2010;80:930-2.
Ashdown DA, Williams D, Davenport K, et al. The impact of medical outliers on elective surgical lists. Ann R Coll Surg Engl 2003;85:46-7.
Warne S, Endacott R, Ryan H, et al. Non-therapeutic omission of medications in acutely ill patients. Nurs Crit Care 2010;15:112-7.
Rae B, Busby W, Millard PH. Fast-tracking acute hospital care--from bed crisis to bed crisis. Aust Health Rev 2007;31:50-62.
Gilligan S, Walters M. Quality improvements in hospital flow may lead to a reduction in mortality. Clin Govern Int J 2007;13:26-34.
Lepage B, Robert R, Lebeau M, et al. Use of a risk analysis method to improve care management for outlying inpatients in a University hospital. Qual Saf Health Care 2009;18:441-5.
Novati R, Papalia R, Peano L, et al. Effectiveness of an hospital bed management model: results of four years of follow-up. Ann Ig 2017;29:189-96.

How to Cite



Not-for-profit observational study to evaluate the quality and safety of care in outliers hospitalized with medical diseases - Study Protocol of Safety Issues and SurvIval For Medical Outliers (SISIFO study). (2021). Italian Journal of Medicine, 15(1). https://doi.org/10.4081/itjm.2021.1447