Impact of Multiprofessional Rounds on Critical Care Outcomes in the Surgical Trauma Intensive Care Unit

Area of Science:

• Critical Care Medicine
• Healthcare Management
• Patient Outcomes Research

Background:

• Multiprofessional rounds (MPR) are crucial for coordinating care in intensive care units (ICUs).
• Implementing standardized MPR guidelines aims to optimize patient management and resource utilization.
• Previous studies suggest potential benefits of MPR, but specific impacts on surgical and trauma populations require further investigation.

Purpose of the Study:

• To evaluate the impact of implementing Multiprofessional Rounds (MPR) on key outcomes in critically ill patients.
• To assess changes in ventilator days (Vent-day), ICU length of stay (LOS), hospital length of stay (HLOS), and mortality following MPR implementation.
• To differentiate the effects of MPR on surgical versus trauma patient cohorts within the ICU.

Main Methods:

• A quasi-experimental study design comparing pre- and post-MPR implementation periods (November 2015 - March 2017).
• Inclusion of patients with Acute Physiology and Chronic Health Evaluation (APACHE) IV and injury severity scores.
• Analysis using linear regression models to assess outcomes including Vent-day, ICU LOS, HLOS, and mortality, with observed/expected ratios (O/E).

Main Results:

• Among 3372 patients, surgical patients (n=2018) showed significant reductions in Vent-day O/E (0.74 to 0.59), ICU LOS O/E (0.67 to 0.61), and HLOS-O/E (1.47 to 1.22) post-MPR.
• Trauma patients (n=1354) experienced a reduction in mean Vent-days (2.2 to 1.6 days) but no significant changes in O/E ratios for Vent-day, ICU LOS, or HLOS.
• No significant differences in mortality were observed for either surgical or trauma groups post-MPR implementation.

Conclusions:

• Implementation of Multiprofessional Rounds (MPR) is associated with improved efficiency in surgical ICU patient care, indicated by reduced length of stay and ventilator days.
• MPR demonstrated a positive impact on resource utilization for surgical patients but less pronounced effects on trauma patients.
• Sustaining the benefits of MPR requires continuous efforts in education and active engagement from the multidisciplinary team.