[Streamlining of medical orders in an intensive care unit]

To We assessed whether intensivists ICU physician acceptance of a system designed to would accept to optimise e their orders for ings of biological samplesings, X-rays and target drugs, and to assess the consequences of this rationalization for on patient's outcome.

Monocentric evaluation of medical economic procedure. The medical ordering process started to be assessed in our ICU in late 2006,

Mat meetings of consultants, registrars and residents, held started on Dec. 21, 2006 with 2-3 2 or 3 times a year sessions a year in order to evaluate the process of medical ordering. The p Physicians and pharmacists provided ordering data at each meeting Orderings of routine samplesings, bedside X-rays and unjustified expansive costly drugs were was discouraged, while targeted sampling ings and lung chest ultrasonography were encouraged. New residents were systematically taught about informed of the this programme. Meanwhile m Monthly morbidity-mortality meetings were pursued in order to assess the consequences impact of this politicspolicy.

While Although ICU total ICU activity increased by 3.4%, and potentially evitable avoidable deaths decreased fell by 34%, % and annual expenses decreased dropped by approximatively about 777 750 000 euros from 2006 to 2008. This cost saving was due to decreased orderings fewer orders in for biological samples y by (-30%), bedside X-rays by (-10%), computed tomographic scans computed tomography by (-16%) and target drugs? by (-35%). However, an increased ordering in use of 4 target drugs was increased observed in between 2008 as compared with 2007 and 2008.

Multidisciplinary optimisation of medical ordering can thus be efficient effective in an in ICU, although. However a profit-sharing with ordering physicians would be necessary to might help to prolong the system.