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- W2525967514 abstract "Rationale: In the intensive care unit (ICU), complex decision making by clinicians and families requires good communication to ensure that care is consistent with the patients’ values and goals.Objectives: To assess the economic feasibility of staffing ICUs with a communication facilitator.Methods: Data were from a randomized trial of an “ICU communication facilitator” linked to hospital financial records; eligible patients (n = 135) were admitted to the ICU at a single hospital with predicted mortality ≥30% and a surrogate decision maker. Adjusted regression analyses assessed differences in ICU total and direct variable costs between intervention and control patients. A bootstrap-based simulation assessed the cost efficiency of a facilitator while varying the full-time equivalent of the facilitator and the ICU mortality risk.Measurements and Main Results: Total ICU costs (mean 22.8k; 95% CI, −42.0k to −3.6k; P = 0.02) and average daily ICU costs (mean, −0.38k; 95% CI, −0.65k to −0.11k; P = 0.006)] were reduced significantly with the intervention. Despite more contacts, families of survivors spent less time per encounter with facilitators than did families of decedents (mean, 25 [SD, 11] min vs. 36 [SD, 14] min). Simulation demonstrated maximal weekly savings with a 1.0 full-time equivalent facilitator and a predicted ICU mortality of 15% (total weekly ICU cost savings, $58.4k [95% CI, $57.7k–59.2k]; weekly direct variable savings, $5.7k [95% CI, $5.5k–5.8k]) after incorporating facilitator costs.Conclusions: Adding a full-time trained communication facilitator in the ICU may improve the quality of care while simultaneously reducing short-term (direct variable) and long-term (total) health care costs. This intervention is likely to be more cost effective in a lower-mortality population." @default.
- W2525967514 created "2016-10-07" @default.
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- W2525967514 date "2016-12-01" @default.
- W2525967514 modified "2023-09-27" @default.
- W2525967514 title "Economic Feasibility of Staffing the Intensive Care Unit with a Communication Facilitator" @default.
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- W2525967514 doi "https://doi.org/10.1513/annalsats.201606-449oc" @default.
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