Variation in sepsis care a wake-up call 英文参考文献.docVIP

Available online /content/7/3/211 Commentary Variation in sepsis care: a wake-up call Mary E Hartman1 and Derek C Angus2 1Research Fellow, CRISMA (Clinical Research, Investigation and Systems Modeling of Acute Illness) Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania, USA 2Vice Chair for Research, Department of Critical Care Medicine, and Director, CRISMA (Clinical Research, Investigation and Systems Modeling of Acute Illness) Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Correspondence: Mary E Hartman, hartme@ Published online: 1 May 2003 Critical Care 2003, 7:211-213 (DOI 10.1186/cc2191) This article is online at /content/7/3/211 ? 2003 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract There is important variation in the care of critically ill patients. While some of this variability is appropriate, and represents individually titrated care, residual variation indicates over- and under-use of precious resources and is clearly concerning. Recent advances in critical care medicine provide “road maps” to standardize care and use evidence-based medicine to improve patient outcomes. Knowledge about which therapies to use, and under what circumstances to use them, could form a basis for measuring the consistency and quality of our care processes. These simple process measures can be easily incorporated into daily rounds and serve to inform on the quality of our care. Keywords critical care, evidence-based medicine, outcome, process assessment, variation In this issue Yu and coworkers [1] present data on variation in treatment patterns for severe sepsis using a large cohort of patients at eight academic medical centers in the USA. This cohort was described previously by the same authors in a landmark paper exploring the epidemiology of severe sepsis [2]. Their new findings are that treatment patterns varied widely across the eight hospitals, despite the fact that the h