The Science Journal of the American Association for Respiratory Care

2002 OPEN FORUM Abstracts

Financial Impact and Clinical Outcomes in Developing A Respiratory Disease Management Unit (RDMU) for Post-ICU weaning Protocol

Loretta Williams, RRT, Robert Fleming, MD, Joseph Lucrezia, RRT, Peggy Danek, RN, Frederick Weinbaum, MD. The New York Hospital Medical Center of Queens, Flushing, New York.

Background: The RDMU was established to expedite early transfer of stable ventilator patients failing spontaneous breathing trials in the intensive care unit (ICU). The purpose of this study is to evaluate cost savings and clinical outcomes of patients on prolonged mechanical ventilation in the acute care setting of a community teaching hospital.

Method: A prospective study was undertaken to assess the impact of the RDMU on ventilator liberation rate, ICU length of stay, hospital length of stay for patients in DRG 483, and total cost saving for the initial six month trial period. The RDMU is a 13 bed non-invasive monitored unit utilizing capnography and oximetry and a patient driven weaning protocol.

Results: There were 114 consecutive admissions to the RDMU in a six month period. Ventilator liberation rate was 61/94 (64.87) for all patients entered in the weaning protocol. Mortality rate was 25/114 (21%) ICU length of stay for DRG 483 decreased by 3.8 days, total hospital stay declined by 8.8 days, total cost savings was $409,500 for the six month study period.

Conclusion: The creation of a specialized unit for weaning leads to a good ventilator liberation rate, decreases in both total ICU and hospital days with substantial financial savings. The reduction in cost is the direct result of investing in a full time respiratory therapist to conduct weaning. This led to confidence in earlier transfer from ICU, ventilator liberation of patients and earlier hospital discharge.

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