RT Journal Article
SR Electronic
T1 Effect of a ventilation multidisciplinary meeting on respiratory patients' journey through critical care
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2161
DO 10.1183/13993003.congress-2015.PA2161
VO 46
IS suppl 59
A1 Abigail Bishopp
A1 Natasha Santana-Vaz
A1 Govindan Raghuraman
A1 Biman Chakraborty
A1 Rahul Mukherjee
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA2161.abstract
AB Introduction: Patient discharge from critical care to appropriate wards represents a challenging and high risk transition. Optimal utilisation of critical care resources requires timely discharge, however local audits revealed that a few multimorbid patients with difficult respiratory weans accounted for 30% of critical care bed days.A weekly ventilation multidisciplinary team (VMDT) meeting combining respiratory and critical care department expertise was established at a 692-bed hospital to improve management and resource use for this patient group.Method: A retrospective comparison of 6 month periods before (period 1: 1/10/07-31/3/08) and after (period 2: 1/10/12-31/3/13) introducing VMDT was carried out using data collected for Intensive Care National Audit & Research Centre. The number of discharges to a respiratory ward with non-invasive ventilation (NIV) facilities and number of level 1 critical care bed days were compared. The same comparison was made in a sister hospital without VMDT.Results: In period 1, there were 458 critical care discharges and 494 in period 2 (p=0.29) with no change in background parameters. The number of patients discharged to respiratory ward with NIV facilities increased significantly from 36 to 65 (p < 0.011) after VMDT. The number of level 1 bed days fell significantly from 208 to 18 (p < 0.0000000001). This change was not observed in the sister hospital.Conclusion: Introduction of VMDT increased the proportion of respiratory patients discharged to a respiratory ward from critical care and reduced level 1 bed days by expediting the discharge of complex respiratory wean patients thereby increasing patient flow and liberating critical care resources.