When patients spend too much time in the intensive care unit, the risk of contracting a hospital-acquired infection and experiencing other complications rises. Therefore, the healthcare improvement company Premier identified ICU diagnoses with the greatest opportunity to reduce length of stay.
To identify the diagnoses, researchers analyzed data on 20 million patient discharges across 786 hospitals from 2011 to 2016. Overall, patients treated at top-performing hospitals spent 24 percent less time in the ICU, which, according to Premier, is indicative of the utility of evidence-based performance improvement efforts. Researchers identified the 10 ICU diagnoses with the largest variation in length-of-stay, making these the areas where improvement efforts may be most effective. Across all discharges, researchers identified opportunities to reduce annual ICU stays by nearly 200,000 days overall.
Here are the 10 ICU diagnoses with the greatest opportunity for length-of-stay reduction.
1. Sepsis patients with major complications or comorbidities — 19 percent of the ICU reduction opportunity
2. Infectious and parasitic diseases associated with operating room procedures, and major complications or comorbidities — 15 percent of the ICU reduction opportunity
3. Cardiac valve and other major cardiothoracic procedures without cardiac catheterization, but with major complications or comorbidities — 12 percent of the ICU reduction opportunity
4. Coronary bypass without cardiac catheterization, but with major complications or comorbidities — 9.8 percent of the ICU reduction opportunity
5. Respiratory system diagnosis with ventilator support for up to 96 hours: 9.5 percent of the ICU reduction opportunity
6. Craniotomy and endovascular intracranial procedures with major complications or comorbidities — 8.9 percent of the ICU reduction opportunity
7. Sepsis patients using a mechanical ventilator longer than 96 hours — 6.8 percent of the ICU reduction opportunity
8. Cardiac valve and other major cardiothoracic procedure with cardiac catheterization and major complications or comorbidities — 6.8 percent of the ICU reduction opportunity
9. Cardiac valve and other major cardiothoracic procedure without a cardiac catheterization, but with complications or comorbidities — 6.1 percent of the ICU reduction opportunity
10. Heart failure and shock with major complications or comorbidities — 6 percent of the ICU reduction opportunity
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