Background Thousands of critically ill patients every year in the United States receive tracheostomy and gastrostomy procedures. Recent research has investigated the benefits of a combined team approach to these procedures, with associated decreases in length of stay (LOS) and hospital costs. This study's objective was to determine if implementing a bedside percutaneous tracheostomy and percutaneous ultrasound gastrostomy (PUG) team would reduce LOS and hospital costs. Design and Methods: This retrospective chart review compares the impact of implementing an ICU bedside percutaneous tracheostomy and PUG service team to the hospital's previous workflow (ie, pre-implementation). Inclusion criteria were adult patients with Ventilator Dependent Respiratory Failure (VDRF), a clinical indication for both procedures while admitted to the ICU and received both tracheostomy and gastrostomy procedures while admitted to the hospital. Pre- and post-implementation groups were compared across patients’ demographics, clinical characteristics, and outcomes. ICU LOS, hospital LOS and total hospital costs were the primary outcome measures. Results: A total of 101 adult critically ill patients were included in the analysis; 49 patients were in the pre-implementation group and 52 patients in the post-implementation group (ie, PUG group). Patients in the PUG group had a significantly shorter mean ICU LOS and hospital LOS, 10.9- and 14.7-day reductions respectively (p = 0.010, p = 0.006). PUG group patients also had a significant reduction in total hospital costs, a per patient cost savings of $34 778 (p = 0.043). Conclusions: This study supports implementing a bedside percutaneous tracheostomy and PUG team to reduce LOS and total hospital costs in patients with VDRF.
- Implementing a Bedside Percutaneous Tracheostomy and Ultrasound Gastrostomy Team Reduces Length of Stay and Hospital Costs Across Multiple Critical Care Units in a 1500 Bed Tertiary Care Center
- Douglas Houghton - Jackson Memorial HospitalSamarth Patel - University of MiamiSergey Gerasim - University of MiamiYaroslav Buryk - University of MiamiNina Massad - University of MiamiAyham Alkhachroum - University of MiamiHany Y. Atallah - Jackson Memorial HospitalKristine O'Phelan - Division of Neurocritical Care, University of Miami Miller School of Medicine, Miami, Florida, USA
- Journal of intensive care medicine, p.8850666241289115
- UMMG Department of Neurology; Miller School of Medicine; UMMG Dept of Medicine - Pulmonary, Critical Care & Sleep Medicine; UMMG Dept of Neurology - Neurocritical Care Div; School of Nursing - Graduate Programs; School of Nursing & Health Studies; UMMG Department of Surgery
- English
- Journal article
- 39436155
- 991032431702202976