Effects of a multifaceted, multidisciplinary, hospital-wide quality improvement program on weaning from mechanical ventilation
Authors
Smyrnios, Nicholas A.Connolly, Ann E.
Wilson, Mark M.
Curley, Frederick J.
French, Cynthia T.
Heard, Stephen O.
Irwin, Richard S.
UMass Chan Affiliations
Department of AnesthesiologyDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care
Document Type
Journal ArticlePublication Date
2002-06-01Keywords
APACHECost Control
Diagnosis-Related Groups
Female
Hospital Mortality
Humans
Length of Stay
Male
Middle Aged
Prospective Studies
Quality of Health Care
Respiration, Artificial
*Ventilator Weaning
Allergy and Immunology
Anesthesiology
Health Services Administration
Metadata
Show full item recordAbstract
OBJECTIVE: To examine the effects of a mechanical ventilation weaning management protocol that was implemented as a hospital-wide, quality improvement program on clinical and economic outcomes. DESIGN: Prospective, before-and-after intervention study. Data from a preimplementation year are compared with those of the first 2 yrs after protocol implementation. PATIENTS AND SETTING: Patients older than 18 yrs in diagnosis-related group 475 and group 483, who were admitted to the adult medical, surgical, and cardiac intensive care units (ICU) in a university hospital. INTERVENTIONS: After the baseline year, a weaning management program was implemented throughout our institution. Primary endpoints were mortality, days on mechanical ventilation, ICU and hospital lengths of stay, hospital costs, and the percentage of patients requiring tracheostomy. MAIN RESULTS: The number of patients increased from 220 in the baseline year (year 0) to 247 in the first year (year 1), then to 267 in the second year (year 2). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score increased from 22.2 to 24.4 in year 1 (p =.006) and to 26.2 in year 2 (p CONCLUSIONS: A multifaceted, multidisciplinary weaning management program can change the process of care used for weaning patients from mechanical ventilation throughout an acute care hospital and across multiple services. This change can lead to large reductions in the duration of mechanical ventilation, length of stay, and hospital costs, even at a time when patients are sicker.Source
Crit Care Med. 2002 Jun;30(6):1224-30.
DOI
10.1097/00003246-200206000-00009Permanent Link to this Item
http://hdl.handle.net/20.500.14038/25790PubMed ID
12072672Related Resources
ae974a485f413a2113503eed53cd6c53
10.1097/00003246-200206000-00009