通过优化医院连续监测系统技术的临床应用来降低重症监护病房（ICU）的使用率、住院时间和成本。

Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital.

作者信息

Dykes Patricia C, Lowenthal Graham, Lipsitz Stuart, Salvucci Suzanne M, Yoon Catherine, Bates David W, An Perry G

机构信息

Center for Patient Safety, Research and Practice, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.

Center for Patient Safety, Research and Practice, Brigham and Women's Hospital, Boston, Mass.

出版信息

Am J Med. 2022 Mar;135(3):337-341.e1. doi: 10.1016/j.amjmed.2021.09.024. Epub 2021 Oct 27.

DOI:10.1016/j.amjmed.2021.09.024

PMID:34717901

Abstract

BACKGROUND

Continuous monitoring system technology (CMST) aids in earlier detection of deterioration of hospitalized patients, but whether improved outcomes are sustainable is unknown.

METHODS

This interrupted time series evaluation explored whether optimized clinical use of CMST was associated with sustained improvement in intensive care unit (ICU) utilization, hospital length of stay, cardiac arrest rates, code blue events, mortality, and cost across multiple adult acute care units.

RESULTS

A total of 20,320 patients in the postoptimized use cohort compared with 16,781 patients in the preoptimized use cohort had a significantly reduced ICU transfer rate (1.73% vs 2.25%, P = .026) corresponding to 367.11 ICU days saved over a 2-year period, generating an estimated cost savings of more than $2.3 million. Among patients who transferred to the ICU, hospital length of stay was decreased (8.37 vs 9.64 days, P = .004). Cardiac arrest, code blue, and mortality rates did not differ significantly.

CONCLUSION

Opportunities exist to promote optimized adoption and use of CMST at acute care facilities to sustainably improve clinical outcomes and reduce cost.

摘要

背景

连续监测系统技术（CMST）有助于更早地发现住院患者的病情恶化，但改善的结果是否可持续尚不清楚。

方法

这项中断时间序列评估探讨了CMST的优化临床应用是否与多个成人急性护理单元在重症监护病房（ICU）利用率、住院时间、心脏骤停发生率、紧急呼叫事件、死亡率和成本方面的持续改善相关。

结果

优化使用后队列中的20320名患者与优化使用前队列中的16781名患者相比，ICU转院率显著降低（1.73%对2.25%，P = 0.026），相当于在两年期间节省了367.11个ICU日，估计成本节省超过230万美元。在转入ICU的患者中，住院时间缩短（8.37天对9.64天，P = 0.004）。心脏骤停、紧急呼叫和死亡率无显著差异。