Paul M Vespa1, Chad Miller, Xiao Hu, Val Nenov, Farzad Buxey, Neil A Martin. 1. Departments of Surgery/Neurological Surgery and Neurology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, Los Angeles, CA 90095, USA. pvespa@mednet.ucla.edu
Abstract
BACKGROUND: The timely assessment and treatment of ICU patients is important for neurosurgeons and neurointensivists. We hypothesized that the use of RTP can improve physician rapid response to unstable ICU patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RTP. Physicians used RTP to make rounds in the ICU in response to nursing pages. Data concerning several aspects of the RTP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RTP were documented. The effect of RTP on ICU length of stay and cost was assessed. RESULTS: The use of RTP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RTP: 9.2 +/- 9.3 minutes vs conventional: 218 +/- 186 minutes). The response latencies to brain ischemia (7.8 +/- 2.8 vs 152 +/- 85 minutes) and elevated ICP (11 +/- 14 vs 108 +/- 55 minutes) were reduced (P < .001), as was the LOS for patients with SAH (2 days) and brain trauma (1 day). There was an increase in ICU occupancy by 11% compared with the prerobot era, and there was an ICU cost savings of $1.1 million attributable to the use of RTP. CONCLUSION: The use of RTP enabled rapid face-to-face attending physician response to ICU patients and resulted in decreased ICU cost and LOS.
BACKGROUND: The timely assessment and treatment of ICU patients is important for neurosurgeons and neurointensivists. We hypothesized that the use of RTP can improve physician rapid response to unstable ICU patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RTP. Physicians used RTP to make rounds in the ICU in response to nursing pages. Data concerning several aspects of the RTP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RTP were documented. The effect of RTP on ICU length of stay and cost was assessed. RESULTS: The use of RTP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RTP: 9.2 +/- 9.3 minutes vs conventional: 218 +/- 186 minutes). The response latencies to brain ischemia (7.8 +/- 2.8 vs 152 +/- 85 minutes) and elevated ICP (11 +/- 14 vs 108 +/- 55 minutes) were reduced (P < .001), as was the LOS for patients with SAH (2 days) and brain trauma (1 day). There was an increase in ICU occupancy by 11% compared with the prerobot era, and there was an ICU cost savings of $1.1 million attributable to the use of RTP. CONCLUSION: The use of RTP enabled rapid face-to-face attending physician response to ICU patients and resulted in decreased ICU cost and LOS.
Authors: Fred Rincon; Matthew Vibbert; Valerie Childs; Robin Fry; Dennis Caliguri; Jacqueline Urtecho; Robert Rosenwasser; Jack Jallo Journal: Neurocrit Care Date: 2012-08 Impact factor: 3.210
Authors: Panayiotis N Varelas; Tamer Abdelhak; Jody Wellwood; Donald Benczarski; Stanton B Elias; Mark Rosenblum Journal: Neurocrit Care Date: 2010-10 Impact factor: 3.210
Authors: Jeremy M Kahn; Nicholas S Hill; Craig M Lilly; Derek C Angus; Judith Jacobi; Gordon D Rubenfeld; Jeffrey M Rothschild; Anne E Sales; Damon C Scales; James A L Mathers Journal: Chest Date: 2011-07 Impact factor: 9.410