A cost-reducing extracorporeal membrane oxygenation (ECMO) program model: a single institution experience

Area of Science:

• Critical Care Medicine
• Cardiopulmonary Support

Background:

• Growing global demand for extracorporeal membrane oxygenation (ECMO) is challenged by high costs and complexity.
• Limited resources and expertise contribute to increased healthcare expenditures for ECMO provision.

Purpose of the Study:

• To evaluate an intensive care unit (ICU)-managed ECMO model without continuous bedside perfusionists.
• To determine if this model reduces costs while maintaining patient safety and clinical outcomes.

Main Methods:

• Implementation of a multidisciplinary ICU-based ECMO program including nurses, mid-level providers, and intensivists.
• Retrospective review comparing a model with continuous perfusionist monitoring (Year 1) versus a model without (Year 2).
• Analysis of patient safety events and cost data before and after removing continuous perfusionist monitoring.

Main Results:

• The ICU-run ECMO model resulted in a 61% cost reduction ($600,264 in Year 1 vs. $234,000 in Year 2).
• Cost savings were linked to reduced perfusion service utilization and adoption of new ECMO technology.
• No significant changes in registered nurse ratios or ICU safety events were observed.

Conclusions:

• An ICU-managed ECMO model can effectively lower hospital costs by optimizing perfusion support.
• This approach demonstrates that cost reduction is achievable without adversely affecting patient safety or outcomes.