Intensive care unit patients
Nurses and nurse aids in intensive care units bathe patients each day using washcloths impregnated with an antiseptic agent, leading to a significant reduction in hospital-acquired infections.
As required by law, hospitals in New York track and report information on select hospital-acquired infections to the State Department of Health, which publicly releases hospital-specific performance data and supports hospitals with quality improvement initiatives; the program has reduced infection rates and generated substantial cost savings.
A comprehensive set of protocols and practices virtually eliminates catheter-related bloodstream infections in the neonatal intensive care unit, generating estimated annual savings of $750,000 to $1,000,000.
Working as part of an “intensive care unit without walls,” critical care physicians (called intensivists) decide which patients require intensive care unit admission and oversee the care of all critically ill patients throughout the hospital, leading to declines in hospital and intensive care unit mortality, improved management of intensive care unit bed capacity, and low intensive care unit length of stay for terminally ill patients.
Pharmacy residents complete one 24-hour shift at a hospital approximately every 2 weeks, providing an array of services, including consultations and assistance with emergency situations; the program has led to low dosing error rates and to high levels of adherence to recommended guidelines for emergency stroke patients and has helped to produce more confident, capable pharmacists.
On-call, pediatric intensive care unit attending physicians consult with onsite clinicians and patient/family members from their homes via audiovisual technology that allows real-time communication, leading to improved quality and timeliness of care and high levels of patient/family satisfaction.
Clinicians in a tertiary hospital continuously monitor and intervene as necessary with critical care patients in rural facilities via telemedicine, leading to reductions in mortality, length of stay, number of patient transfers, and costs.
As part of a hospital collaborative, intensive care units implemented a multifaceted safety program that reduced infections and hospital days, saved lives, and lowered health care costs.
Intensivists guide care around the clock in two medical–surgical intensive care units, leading to lower length of stay and the near elimination of ventilator-associated pneumonia, hospital-acquired pressure ulcers, and central line infections.
A simple scoring system allows nurses to quickly recognize patients likely to deteriorate and mobilize resources to assist them, leading to an increase in calls to the hospital rapid response team and a reduction in “code blue” (cardiopulmonary) emergencies.