LACONIA, NH – In the spring of 2015, the LRGHealthcare Intensive Care Unit (ICU) was selected among 69 adult ICUs nationwide to participate in a national quality improvement initiative called the ICU Liberation Campaign ABCDEF Bundle Collaborative. At the project wrap up meeting recently, LRGHealthcare was recognized as the top community hospital on the East Coast for performing spontaneous breathing trials (SBTs) in an effort to get patients off life support sooner, which has been shown to decrease patient mortality.
LRGHealthcare was also recognized as a top performer for engaging families in their loved-one’s care with the goal of making them part of the healthcare team. Family involvement is an important component of helping patients get better quicker. For example, studies have shown that a family member can tell when their loved one is in pain better than the nurse and doctor can.
The goal of the ICU Liberation Collaborative was to translate research into practice and improve patient outcomes in the critically ill. Over 100 peer reviewed publications support the interventions included in the ABCDEF Bundle in the ICU, but it had never been evaluated in a real-world setting on a large scale.
Each letter of the ABCDEF bundle represents an intervention. These interventions included improved pain management, spontaneous breathing trials on the ventilator (a form of life support), reduced sedative exposure, delirium screening, early physical therapy, and increased family engagement.
The LRGHealthcare ICU staff had patients up and walking while on the ventilator, started bedside rounds with patients’ families and significantly decreased the use of a class of sedative medications known as benzodiazepines, which are known to cause ICU delirium and prolong time on life support. After 20 months of collecting data, the results are positive. The median length of stay in the ICU decreased from five days to three days and for those same patients, overall hospital length of stay decreased from eight days to six.
Project leader and LRGHealthcare Pharmacist, Michael Smith, PharmD, BCCCP notes, “The project was truly a multidisciplinary project and would not have been a success without buy-in and involvement from the physicians, nursing, respiratory therapy, pharmacy, physical therapy, care management, quality, marketing, and administration. While the collaborative is officially over, we will need to continue to work to maintain our successes and improve upon what we have done.”
Left to Right: Wes Ely, MD, leader of the collaborative with Stephanie Wheeler, RN, LRGHealthcare Director of Critical Care Services and Michael P. Smith, PharmD, BCCCP, LRGHealthcare Pharmacist.
LRGHealthcare is a not-for-profit healthcare charitable trust representing Lakes Region General Hospital, Franklin Regional Hospital, and affiliated medical providers. LRGHealthcare’s mission is to provide quality, compassionate care and to strengthen the well-being of our community.
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