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January 12, 2017

UCMC Study Discovers Impact of "Neighborhood Effect" in Hospitals

Research that was published in The Journal of the American Medical Association (JAMA) by University of Chicago physicians recently found that when patients in a hospital unit suffered from major setbacks, other patients in the same unit were at risk from undergoing a comparable crisis.

When patients in a hospital unit underwent critical-illness events, the risk of another patient in the same unit experiencing a comparable crisis increased by 18 percent. Critical-illness events encompass cardiac arrests, urgent ICU transfers and patient deaths.

“We suspected this phenomenon based on our own anecdotal experience,” said Samuel Volchenboum to Science Life – the online news hub for the University of Chicago Medicine and Biological Sciences. Volchenboum is a co-author of the study, the associate professor of pediatrics at the University of Chicago and the director of the University’s Center for Research Informatics.

The study is in line with a concept in social science called the neighborhood effect: where environments can have a direct or indirect effect on individual behaviors.

Researchers speculate that a factor for this phenomenon could be the diversion of resources. When resources are diverted to one patient experiencing a critical-illness event, other patients will naturally receive less attention, so are at higher risk of suffering a critical-illness event due to lack of care.

Results from the research show that when two critical-illness events happened during a six-hour time period, the risk of another incident rose from 18 percent to 53 percent. Risks were also slightly higher when the initial critical-illness events occurred at night.

Researchers were careful not to make any speculations. “Further study is needed to determine the causes of this effect,” Volchenboum added.

The University of Chicago Medicine mandates thoroughness from its rapid response team after dealing with a critical-illness event. The team has to ask the acting nurses from the hospital ward where the critical-illness event occurred, what other patients the nurses are worried about, and to check on those patients.

“This should serve as a wake-up call for hospital-based physicians,” said Matthew Churpek, the study author and an assistant professor of medicine at the University of Chicago, to Science Life. “Our data suggests that after caring for a patient who becomes critically ill on the hospital wards, we should routinely check to see how the other patients on the unit are doing.”

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