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Intensive care unit improves dialysis care quality while reducing costs.

Tara Greenleaf Nichols1, David Doman1, Sherrie Mullen1

  • 1Department of Nephrology, Covenant HealthCare, Saginaw, MI, USA.

Journal of Medical Economics
|June 7, 2024
PubMed
Summary

Transitioning to an in-house prolonged intermittent renal replacement therapy (PIRRT) service improved ICU outcomes and nurse productivity while reducing costs. This quality improvement project demonstrates the benefits of insourcing RRT with innovative technology.

Keywords:
II00I1I12Renal replacement therapycontinuous renal replacement therapyintensive care unitintermittent renal replacement therapy

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Area of Science:

  • Nephrology
  • Intensive Care Medicine
  • Health Services Research

Background:

  • Outsourced conventional dialysis in ICUs presents challenges in cost and nursing burden.
  • Transitioning to an in-house model is a key quality improvement initiative.

Purpose of the Study:

  • Evaluate the impact of insourcing prolonged intermittent renal replacement therapy (PIRRT) on clinical outcomes, nursing workload, and costs.
  • Assess the effectiveness of the Tablo Hemodialysis System for PIRRT and 24-hour treatments.

Main Methods:

  • A descriptive comparative analysis of RRT before and after implementing an in-house PIRRT program.
  • Utilized the Tablo Hemodialysis System for PIRRT and sequential 24-hour treatments.

Main Results:

  • Reduced mean dialysis treatment hours per patient by over 50% post-transition.
  • Increased ICU nurse productivity by 50.2 hours per patient.
  • Observed a decline in ICU length of stay (4.8 days) and ICU mortality (9.8 percentage points).

Conclusions:

  • Insourcing RRT with innovative technology like the Tablo system can maintain or improve clinical outcomes in critically ill patients.
  • This model effectively reduces dialysis-related costs and nursing staff burden in the ICU.