Study: 5-point intervention cuts surgical ICU days by nearly 5%

A study, published in JAMA Surgery, found potentially avoidable surgical intensive care unit admissions and disposition delays are frequent.

Researchers investigated potentially avoidable surgical ICU days at an urban, academic hospital before and after targeted interventions are implemented.

The interventions include:

•    Reducing surgical ICU care for minor traumatic brain injury
•    Optimizing postoperative airway management
•    Enhancing communication between services regarding transfers to the surgical ICU
•    Identifying and facilitating more timely end-of-life conversations and supportive care consultations
•    Encouraging early disposition of patients to floor beds

Researchers implemented the interventions from July 1, 2015, through March 31, 2016. They examined all 459 patients admitted to the surgical ICU during the pre-intervention and post-intervention phases.

The study shows nearly one-fourth of surgical ICU days could be categorized as potentially avoidable. The median surgical ICU and hospital length of stay remained the same for the 261 patients admitted during the pre-intervention period and 245 during the post-intervention period.

However, researchers noted a decrease in the percentage of surgical ICU days due to potentially avoidable admissions in the post-intervention period — 13 percent in the pre-intervention period dropped by nearly 5 percent to 8.8 percent.

Disposition delays also decreased, from 11.8 percent in the pre-intervention period to 7.2 percent in the post-intervention period.

The overall rate of potentially avoidable days also dropped between the two time periods, from 23 percent to 15.3 percent.

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