Adeel A Butt1, Nawal Al Kaabi, Mohammed Saifuddin, Kalpana M Krishnanreddy, Maqsood Khan, Waleed H Jasim, Tehmina Khan, Masalam Sara, Marthinus Pitout, Stefan Weber. 1. Hamad Healthcare Quality Institute (AAB), Hamad Medical Corporation, Doha, Qatar; Department of Medicine, University of Pittsburgh School of Medicine (AAB), Pittsburgh, Pennsylvania; Departments of Pediatrics (NAK), Department of Medicine (TK), Pharmacy (MS, MK), Critical Care Medicine (KMK, WHJ, MS), Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; and Institute of Laboratory Medicine (MP, SW), Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Abstract
BACKGROUND: Infectious disease (ID) clinicians and multidisciplinary teams may have a beneficial impact on patient outcomes. This study was conducted to determine the impact of dedicated ID team rounding in an adult noncardiac intensive care unit (ICU) on antimicrobial costs, length of stay and mortality. METHODS: The authors instituted dedicated ICU ID team rounds at a large tertiary care hospital ICU ("intervention"), with the ID team conducting rounds in the ICU every weekday. The authors compared the cost of antimicrobial agents, total hospital and ICU length of stay and inpatient mortality for the 6-month period before and after institution of these rounds between those seen versus those not seen by the ID team. RESULTS: Among 386 patients analyzed, 206 were admitted in the preintervention and 180 in the postintervention period. Among those seen by the ID team, there was an 18% decrease in total antimicrobial cost (P < 0.0001), 40% decrease in ICU length of stay (P = 0.1), 33% decrease in overall hospital length of stay (P = 0.03) and 34% decrease in mortality (0.04) from preintervention to postintervention period. Among those not seen by ID, there was a 39% decrease in cost among those not seen by ID (P < 0.0001), but length of ICU or hospital stay and mortality were not significantly different. CONCLUSIONS: Institution of dedicated ID team rounding in the ICU leads to substantial decreases in antimicrobial costs, hospital length of stay and inpatient mortality among those patients seen by the team.
BACKGROUND:Infectious disease (ID) clinicians and multidisciplinary teams may have a beneficial impact on patient outcomes. This study was conducted to determine the impact of dedicated ID team rounding in an adult noncardiac intensive care unit (ICU) on antimicrobial costs, length of stay and mortality. METHODS: The authors instituted dedicated ICU ID team rounds at a large tertiary care hospital ICU ("intervention"), with the ID team conducting rounds in the ICU every weekday. The authors compared the cost of antimicrobial agents, total hospital and ICU length of stay and inpatient mortality for the 6-month period before and after institution of these rounds between those seen versus those not seen by the ID team. RESULTS: Among 386 patients analyzed, 206 were admitted in the preintervention and 180 in the postintervention period. Among those seen by the ID team, there was an 18% decrease in total antimicrobial cost (P < 0.0001), 40% decrease in ICU length of stay (P = 0.1), 33% decrease in overall hospital length of stay (P = 0.03) and 34% decrease in mortality (0.04) from preintervention to postintervention period. Among those not seen by ID, there was a 39% decrease in cost among those not seen by ID (P < 0.0001), but length of ICU or hospital stay and mortality were not significantly different. CONCLUSIONS: Institution of dedicated ID team rounding in the ICU leads to substantial decreases in antimicrobial costs, hospital length of stay and inpatient mortality among those patients seen by the team.
Authors: Takaaki Kobayashi; Alexandre R Marra; Marin L Schweizer; Patrick Ten Eyck; Chaorong Wu; Mohammed Alzunitan; Jorge L Salinas; Marc Siegel; Dimitrios Farmakiotis; Paul G Auwaerter; Heather S Healy; Daniel J Diekema Journal: Open Forum Infect Dis Date: 2020-08-03 Impact factor: 3.835