REDUCING LENGTH OF STAY AND IMPROVING QUALITY OF CARE BY IMPLEMENTATION OF INFORMATICS SYSTEM AND CARE BUNDLE IN THE INTENSIVE CARE UNIT.

ABSTRACT

BACKGROUND: Clinical situations in intensive care units (ICUs) change rapidly, and many factors may prolong the length of stay (LOS) of patients. OBJECTIVES: The objectives of the study were to examine the effects of implementing an electronic-ICU (e-ICU) and an informatics system in an ICU on the LOS of patients and quality of care. METHODS: We evaluated the implementation of a technology electronic dashboard-ICU (TED-ICU) system to upload automatically physiological information and clinical data within the critical care unit for providing real-time information to the care team. Furthermore, TED-ICU software automatically performed Sequential Organ Failure Assessment (SOFA) every 48 h. If a patient's SOFA score decreased by more than 2 points, there was an automatic reminder for transferring patients to the general ward. We prospectively collected data for this study from the ICU before and after implementing the e-ICU. RESULTS: In total, 2248 patients were admitted to our ICU during the study period (1147 and 1101 patients before and after TED-ICU implementation, respectively). Demographic characteristics and in-hospital mortality rates did not differ significantly between the two groups, and the LOS decreased from 7.26 to 5.53 days (p < 0.01). CONCLUSION: Implementing an informatics system (TED-ICU) and care bundle in ICUs can reduce the LOS.