Browsing by Author "Boyd, Jamie"
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- ItemOpen AccessDevelopment and Evaluation of Risk Models to Predict Readmission or Death Following Discharge from an Adult General Systems Intensive Care Unit(2018-07-06) Boyd, Jamie; Stelfox, Henry Thomas; James, Matthew T.; Zuege, Danny J.Transitions of care from intensive care unit (ICU) to ward are high-risk periods of healthcare delivery associated with ICU readmission and post-ICU mortality. Evidence-based processes for transitions are crucial for improving outcomes. Validated prediction models that include consistently associated risk factors for ICU readmission or post-ICU mortality may help to improve these practices. This mixed-methods thesis was comprised of three distinct phases: 1) systematic review and meta-analysis; 2) development of prediction models for ICU Readmission and Post-ICU Mortality using two approaches (literature-derived coefficients, data-derived coefficients [Derivation Cohort]), 3) validation of the models in an external Validation Cohort. The models for ICU Readmission showed limited discriminative ability whereas the Post-ICU Mortality models were stronger. Developing prediction models using pooled measures of association is a feasible approach, producing similar results to more the traditional data-derived method. Additional investigation to further validate the findings is required.
- ItemOpen AccessShort form version of the Quality of Trauma Care Patient-Reported Experience Measure (SF QTAC-PREM)(2017-12-06) Bobrovitz, Niklas; Santana, Maria J; Boyd, Jamie; Kline, Theresa; Kortbeek, John; Widder, Sandy; Martin, Kevin; Stelfox, Henry TAbstract Objective To enable the valid and reliable measurement of patient experiences we previously published a multicenter multi-center validation of the Quality of Trauma Care Patient-Reported Experience Measure (QTAC-PREM). The purpose of this study was to derive a simplified, short form version of the QTAC-PREM to further enhance the feasibility of measuring patient experiences in injury care. To identify candidate items for the short form we reviewed the results of the original multi-center long form validation cohort study, which included 400 injury care patients and their family members recruited from three trauma centers. We only included the best performing items on the revised short form. Results The acute care component of the measure was shortened by 30% and the post-acute care component was shortened by 42%. We identified two subscales on the acute measure (information and communication; clinical and ancillary care) and one subscale on the post-acute measure (post-discharge information and communication). The measurement properties of the short form measure were similar to that of the validated long form. This short form assessment of patient injury care experiences offers a useful, practical, and easy tool for trauma centers to implement for service evaluation, quality improvement, and injury care research.