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Affiliations

Carolinas Medical Center

Presentation Notes

Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

(Background) Improving patient flow and addressing the increased need for Intensive care unit beds requires innovative protocols and guidelines to remove barriers and mobilize resources effectively.

(Local Problem) An intense need to decompress Intensive care volume for non-critical patients was identified. Starting July 2023, multiple cardiac intermediate units in a large academic facility developed and implemented high acuity designated beds to reduce the cancellation/rescheduling of open-heart surgeries and maximize bed availability in two cardiac Intensive care units.

(Method) Care modalities were developed through collaboration between nursing, providers, pharmacy, patient placement, finance, and educators. Nursing practice standards were created to address increased monitoring protocols, enhanced medication and vascular access device management, and advanced critical thinking skills. Educators created a high acuity orientation program with interactive didactic approaches. Interdisciplinary partnerships aided in effective financial strategies, enhanced Intravenous Monitoring Guidelines, and detailed Bed Designation Criteria.

(Results/Conclusions) Through a strategic incremental implementation process, patients have been efficiently transitioned to the high acuity unit from the cardiac Intensive care unit allowing for better utilization of critical care beds that remain in high demand. 84.07 ICU days were saved from July – December 2023 and with increased High Acuity capacity, 129.44 ICU days saved in the first quarter. Financial impact to patients were approximately $2200/day, with an estimated total cost avoidance of $469,722. Patient experience scores were sustained at 80th percentile throughout implementation of high acuity.

(Implication for Practice) Improvement in patient flow and addressing the increased need for Intensive care beds requires innovative protocols and guidelines to remove barriers and mobilize resources. Identifying the need for high acuity beds improved bed capacity and flow, decreased utilization of Intensive care beds, and positively impacted patient experience. Feedback from patients reflected high satisfaction in patient care. Schedule of cardiac surgeons, complexity of care, and physician buy-in presented as challenges. Strategies to address these will be discussed.

Document Type

Poster

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

Cardiac High Acuity - An ICU Bed Solution

(Background) Improving patient flow and addressing the increased need for Intensive care unit beds requires innovative protocols and guidelines to remove barriers and mobilize resources effectively.

(Local Problem) An intense need to decompress Intensive care volume for non-critical patients was identified. Starting July 2023, multiple cardiac intermediate units in a large academic facility developed and implemented high acuity designated beds to reduce the cancellation/rescheduling of open-heart surgeries and maximize bed availability in two cardiac Intensive care units.

(Method) Care modalities were developed through collaboration between nursing, providers, pharmacy, patient placement, finance, and educators. Nursing practice standards were created to address increased monitoring protocols, enhanced medication and vascular access device management, and advanced critical thinking skills. Educators created a high acuity orientation program with interactive didactic approaches. Interdisciplinary partnerships aided in effective financial strategies, enhanced Intravenous Monitoring Guidelines, and detailed Bed Designation Criteria.

(Results/Conclusions) Through a strategic incremental implementation process, patients have been efficiently transitioned to the high acuity unit from the cardiac Intensive care unit allowing for better utilization of critical care beds that remain in high demand. 84.07 ICU days were saved from July – December 2023 and with increased High Acuity capacity, 129.44 ICU days saved in the first quarter. Financial impact to patients were approximately $2200/day, with an estimated total cost avoidance of $469,722. Patient experience scores were sustained at 80th percentile throughout implementation of high acuity.

(Implication for Practice) Improvement in patient flow and addressing the increased need for Intensive care beds requires innovative protocols and guidelines to remove barriers and mobilize resources. Identifying the need for high acuity beds improved bed capacity and flow, decreased utilization of Intensive care beds, and positively impacted patient experience. Feedback from patients reflected high satisfaction in patient care. Schedule of cardiac surgeons, complexity of care, and physician buy-in presented as challenges. Strategies to address these will be discussed.

 

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