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A 5-Year Trend in Resource Utilization in the Intensive Care Unit FREE TO VIEW

Perliveh Carrera; Charat Thongprayoon; Adil Ahmed
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Mayo Clinic, Rochester, MN

Chest. 2014;146(4_MeetingAbstracts):499A. doi:10.1378/chest.1995168
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SESSION TITLE: Outcomes/Quality Control Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: While intensive care units (ICU) only represent 5-10% of all hospital beds, they consume more than 30% of healthcare costs. Over the years, many quality improvement measures have aimed at promoting efficient use of limited resources in the ICU. This study aims to evaluate the trend of resource utilization in our ICU over the past 5 years from 2008-2012.

METHODS: We ran the electronic query looking for certain resource utilizations according to pre-defined algorithms among patients admitted to the ICU at Mayo Clinic, Rochester from January 2008 to December 2012 and residing in Olmsted County, MN. The resource utilization included central lines, urinary catheters, vasopressor use, continuous sedation, and antibiotic use. The proportion of ICU days with certain utilized resources over the total number of ICU days were reported over the 5-year period.

RESULTS: A total of 14 036 ICU admissions for 8 632 patients were included in analysis, resulting in 51 511 patient*day in ICU. The proportion of ICU days with antibiotics was 0.41 in 2008, 0.46 in 2009, 0.56 in 2010, 0.64 in 2011 and 0.51 in 2012. The proportion of ICU days with a central line was 0.43 in 2008, 0.42 in 2009, 0.43 in 2010, 0.51 in 2011 and 0.39 in 2012. The proportion of ICU days with continuous sedation was 0.22 in 2008, 0.21 in 2009, 0.18 in 2010, 0.16 in 2011 and 0.12 in 2012. The proportion of ICU days with a urinary catheter was 0.75 in 2008, 0.73 in 2009, 0.69 in 2010, 0.61 in 2011 and 0.50 in 2012. The proportion of ICU days with vasopressor use was 0.11 in 2008, 0.14 in 2009, 0.13 in 2010, 0.11 in 2011 and 0.08 in 2012.

CONCLUSIONS: Over the 5-year period from 2008-2012, there was a trend toward the reduction of resource utilization in urinary catheters, continuous sedation and vasopressor use. In contrast, the use of antibiotics and central lines initially increased until 2011 and then decreased in 2012.

CLINICAL IMPLICATIONS: The finding indicates the possibility of a more efficient use of certain resources in our ICU. This may result from the increased awareness of proper resource utilization among ICU providers and quality improvement measures implemented in ICU.

DISCLOSURE: The following authors have nothing to disclose: Perliveh Carrera, Charat Thongprayoon, Adil Ahmed

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