Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital
Continuous monitoring system technology (CMST) aids in earlier detection of deterioration of hospitalized patients, but whether improved outcomes are sustainable is unknown. This interrupted time series evaluation explored whether optimized clinical use of CMST was associated with sustained improvem...
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Veröffentlicht in: | The American journal of medicine 2022-03, Vol.135 (3), p.337-341.e1 |
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container_issue | 3 |
container_start_page | 337 |
container_title | The American journal of medicine |
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creator | Dykes, Patricia C. Lowenthal, Graham Lipsitz, Stuart Salvucci, Suzanne M. Yoon, Catherine Bates, David W. An, Perry G. |
description | Continuous monitoring system technology (CMST) aids in earlier detection of deterioration of hospitalized patients, but whether improved outcomes are sustainable is unknown.
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.
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.
Opportunities exist to promote optimized adoption and use of CMST at acute care facilities to sustainably improve clinical outcomes and reduce cost. |
doi_str_mv | 10.1016/j.amjmed.2021.09.024 |
format | Article |
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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.
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.
Opportunities exist to promote optimized adoption and use of CMST at acute care facilities to sustainably improve clinical outcomes and reduce cost.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2021.09.024</identifier><identifier>PMID: 34717901</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Adverse events ; Continuous monitoring ; Failure to rescue ; Heart Arrest - therapy ; Hospital ; Hospital Mortality ; Hospitals ; Humans ; Intensive Care Units ; Length of Stay ; Technology</subject><ispartof>The American journal of medicine, 2022-03, Vol.135 (3), p.337-341.e1</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-8ab7df31fabbde951d8c2355fa91ced585688141c22a93989792c6748511fea63</citedby><cites>FETCH-LOGICAL-c362t-8ab7df31fabbde951d8c2355fa91ced585688141c22a93989792c6748511fea63</cites><orcidid>0000-0003-4597-0732</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002934321006987$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34717901$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dykes, Patricia C.</creatorcontrib><creatorcontrib>Lowenthal, Graham</creatorcontrib><creatorcontrib>Lipsitz, Stuart</creatorcontrib><creatorcontrib>Salvucci, Suzanne M.</creatorcontrib><creatorcontrib>Yoon, Catherine</creatorcontrib><creatorcontrib>Bates, David W.</creatorcontrib><creatorcontrib>An, Perry G.</creatorcontrib><title>Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Continuous monitoring system technology (CMST) aids in earlier detection of deterioration of hospitalized patients, but whether improved outcomes are sustainable is unknown.
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.
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.
Opportunities exist to promote optimized adoption and use of CMST at acute care facilities to sustainably improve clinical outcomes and reduce cost.</description><subject>Adult</subject><subject>Adverse events</subject><subject>Continuous monitoring</subject><subject>Failure to rescue</subject><subject>Heart Arrest - therapy</subject><subject>Hospital</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Technology</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhDRDykUMTbCdO4gsSiqCttKgS7Z4tx5nsziqxl9hBSp-Bh27CtldO1sjfNzP2T8hHzlLOePHlmJrhOECbCiZ4ylTKRP6KbLiUMil5IV6TDWNMJCrLswvyLoTjUjIli7fkIstLXirGN-TvL2gni25Pb-sd3UXs8dFE9O6KbsHt44H6jt5HM19R41pa-xBpM9O7U8QBH1cvHoDWPTq0pqe7AKtQexfRTX4K9Kd3GP24kvdziDDQB7AH53u_nym6f_qNDyeMpn9P3nSmD_Dh-bwkux_fH-qbZHt3fVt_2yY2K0RMKtOUbZfxzjRNC0rytrIik7IziltoZSWLquI5t0IYlalKlUrYoswryXkHpsguyedz39Pof08Qoh4wWOh742DZWQupuOC5yqsFzc-oHX0II3T6NOJgxllzptcc9FGfc9BrDpopveSwaJ-eJ0zNevcivXz8Anw9A7C88w_CqINFcMv6OIKNuvX4_wlPqx-cDw</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Dykes, Patricia C.</creator><creator>Lowenthal, Graham</creator><creator>Lipsitz, Stuart</creator><creator>Salvucci, Suzanne M.</creator><creator>Yoon, Catherine</creator><creator>Bates, David W.</creator><creator>An, Perry G.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4597-0732</orcidid></search><sort><creationdate>202203</creationdate><title>Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital</title><author>Dykes, Patricia C. ; Lowenthal, Graham ; Lipsitz, Stuart ; Salvucci, Suzanne M. ; Yoon, Catherine ; Bates, David W. ; An, Perry G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-8ab7df31fabbde951d8c2355fa91ced585688141c22a93989792c6748511fea63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Adverse events</topic><topic>Continuous monitoring</topic><topic>Failure to rescue</topic><topic>Heart Arrest - therapy</topic><topic>Hospital</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Technology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dykes, Patricia C.</creatorcontrib><creatorcontrib>Lowenthal, Graham</creatorcontrib><creatorcontrib>Lipsitz, Stuart</creatorcontrib><creatorcontrib>Salvucci, Suzanne M.</creatorcontrib><creatorcontrib>Yoon, Catherine</creatorcontrib><creatorcontrib>Bates, David W.</creatorcontrib><creatorcontrib>An, Perry G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dykes, Patricia C.</au><au>Lowenthal, Graham</au><au>Lipsitz, Stuart</au><au>Salvucci, Suzanne M.</au><au>Yoon, Catherine</au><au>Bates, David W.</au><au>An, Perry G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2022-03</date><risdate>2022</risdate><volume>135</volume><issue>3</issue><spage>337</spage><epage>341.e1</epage><pages>337-341.e1</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><abstract>Continuous monitoring system technology (CMST) aids in earlier detection of deterioration of hospitalized patients, but whether improved outcomes are sustainable is unknown.
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.
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.
Opportunities exist to promote optimized adoption and use of CMST at acute care facilities to sustainably improve clinical outcomes and reduce cost.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34717901</pmid><doi>10.1016/j.amjmed.2021.09.024</doi><orcidid>https://orcid.org/0000-0003-4597-0732</orcidid></addata></record> |
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subjects | Adult Adverse events Continuous monitoring Failure to rescue Heart Arrest - therapy Hospital Hospital Mortality Hospitals Humans Intensive Care Units Length of Stay Technology |
title | Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital |
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