Researchers from Northwest Hospital and Lifebridge Critical Care in Randallstown, Md. conducted a study of patients with sepsis admitted in the ICU and found that a significant decrease in mortality, ICU length of stay, and intermediate care unit-to-ICU transfers occurred when a collaborative culture was created between the ED and ICU.
This retrospective study focused on 886 medical records from patients with sepsis and compared mortality and length of stay before and after making ICU admission criteria less stringent. Upon implementation, overall mortality decreased by 45.4 percent, from 14.38 percent to 7.85 percent. Though the severity of the illness did not change, ICU length of stay was 25.9 percent lower in the postimplementation cohort (3.97 days vs 2.94 days). The number of intermediate care unit patients who were transferred also decreased by 67.1 percent, from 3.89 percent to 1.28 percent. Results show that developing a collaborative culture and standardized ICU admission criteria for patients with sepsis not only provides smarter use of ICUs but may also help improve annual cost savings in hospitals, as well.
"Although ICU level of care is costly, earlier inclusion of borderline patients may improve mortality," says Dr. Joseph Carrington, of Northwest Hospital and lead researcher. "It may also significantly decrease resource utilization, as our study found."
Source: American College of Chest Physicians