Reducing ICU Utilization, Length of Stay, and Cost by Optimizing the Clinical Use of Continuous Monitoring System Technology in the Hospital

Am J Med. 2022 Mar;135(3):337-341.e1. doi: 10.1016/j.amjmed.2021.09.024. Epub 2021 Oct 27.

Abstract

Background: Continuous monitoring system technology (CMST) aids in earlier detection of deterioration of hospitalized patients, but whether improved outcomes are sustainable is unknown.

Methods: This interrupted time series evaluation explored whether optimized clinical use of CMST was associated with sustained improvement in intensive care unit (ICU) utilization, hospital length of stay, cardiac arrest rates, code blue events, mortality, and cost across multiple adult acute care units.

Results: A total of 20,320 patients in the postoptimized use cohort compared with 16,781 patients in the preoptimized use cohort had a significantly reduced ICU transfer rate (1.73% vs 2.25%, P = .026) corresponding to 367.11 ICU days saved over a 2-year period, generating an estimated cost savings of more than $2.3 million. Among patients who transferred to the ICU, hospital length of stay was decreased (8.37 vs 9.64 days, P = .004). Cardiac arrest, code blue, and mortality rates did not differ significantly.

Conclusion: Opportunities exist to promote optimized adoption and use of CMST at acute care facilities to sustainably improve clinical outcomes and reduce cost.

Keywords: Adverse events; Continuous monitoring; Failure to rescue; Hospital.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Heart Arrest* / therapy
  • Hospital Mortality
  • Hospitals
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Technology