(1246) Reducing ICU Readmissions: The Impact of Collaborative Multiprofessional Rounds on ICU Liberation

Introduction: The Intensive Care Unit (ICU) Liberation Bundle is an internationally accepted model for coordinated critical care delivery. In our Surgical Trauma Intensive Care Unit (STICU) the implementation of a multiprofessional team with structured and collaborative goal setting rounds on day and night shift was established to optimize care delivery. We hypothesize that with structured collaboration amongst multiprofessionals, we would improve clinical outcomes of STICU patients.

Methods: This is a retrospective study using prospectively collected data from our institutional ICU Datamart. The PRE group included patients admitted from January 2019 to December 2019, and the POST group included patients admitted from July 2022 to June 2023. Patients were excluded if they had ICU length of stay (LOS) < 48 hours. The day multiprofessional team consists of a clinical nurse leader, respiratory therapy, dietician, physical/occupational therapy, case management, and physician/advanced care provider. The night multiprofessional team consists of clinical nurse leader, respiratory therapy, and physician/advanced care provider. Clinical contributions and goal setting was scripted to ensure consistency. Patient demographics, STICU length of stay, vent duration, mortality, and readmission rates were collected.

Results: In the PRE group, 1147 patient were included with median age 58 and 64% male gender. In the POST group 1298 patients were included with median age 57 and 66% male gender (p > 0.05 for age and gender). Ventilator duration was similar between groups, PRE 8 days and POST 8.6 days (p 0.06). Median ICU LOS was increased in the POST group, PRE 4 days and POST 4 days (p 0.0001). Mortality was similar between groups, 10% in the PRE group and 9% in the POST group (p .23). Readmission rates were significantly reduced in the POST group 17.5% compared to 25% in the PRE group (p 0.001).

Conclusions: Implementation of a collaborative multiprofessional team with structured day and night shift rounds addressing ICU Liberation Bundle components with focused goal setting and barrier mitigation can reduce readmission rates to the ICU. Although ICU LOS, ventilator duration, and mortality were not reduced, this may be due to higher acuity of critical illness in the POST group and will be investigated further in the future.