Academic Journal
The Economic and Clinical Impact of Sustained Use of a Progressive Mobility Program in a Neuro-ICU*
| العنوان: | The Economic and Clinical Impact of Sustained Use of a Progressive Mobility Program in a Neuro-ICU* |
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| المؤلفون: | Hester, Jeannette M., Guin, Peggy R., Danek, Gale D., Thomas, Jaime R., Titsworth, William L., Reed, Richard K., Vasilopoulos, Terrie, Fahy, Brenda G. |
| المصدر: | Critical Care Medicine ; volume 45, issue 6, page 1037-1044 ; ISSN 0090-3493 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2017 |
| الوصف: | Objective: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. Design: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital. Setting: Thirty-bed neuro-ICU in an academic medical center. Patients: Adult neurologic and neurosurgical patients: 1,118 patients in the pre period, 731 patients in the post period, and 796 patients in the sustained period. Interventions: Implementation of Progressive Upright Mobility Protocol Plus. Measurements and Main Results: ICU length of stay decreased from 6.5 to 5.8 days in the immediate post period and 5.9 days in the sustained period ( F (2,2641) = 3.1; p = 0.045). Hospital length of stay was reduced from 11.3 ± 14.1 days to 8.6 ± 8.8 post days and 8.8 ± 9.3 days sustained ( F (2,2641) = 13.0; p < 0.001). The impact of the study intervention on ICU length of stay ( p = 0.031) and hospital length of stay ( p < 0.001) remained after adjustment for age, sex, diagnoses, sedation, and ventilation. Hospital-acquired infections were reduced by 50%. Average total cost per patient after adjusting for inflation was significantly reduced by 16% (post period) and 11% (sustained period) when compared with preintervention ( F (2,2641) = 3.1; p = 0.045). Overall, these differences translated to an approximately $12.0 million reduction in direct costs from February 2011 through the end of 2013. Conclusions: An ongoing progressive mobility program in the neurocritical care population has clinical and financial benefits associated with its implementation and should be considered. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/ccm.0000000000002305 |
| الاتاحة: | http://dx.doi.org/10.1097/ccm.0000000000002305 https://journals.lww.com/00003246-201706000-00015 |
| رقم الانضمام: | edsbas.828F463 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/ccm.0000000000002305 |
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