A Multifunction Neurosciences Intensive Care Unit Lumbar Puncture Service Improves Efficiency and Delivers...

To enhance the multifunctional efficacy and cost efficiency of lumbar puncture (LP) services for optimal patient outcomes.

In January 2023, the neurosciences intensive care unit (NeuroICU) created a day team (Team 2) to offload time-sensitive tasks from the 24-hour service team (Team 1). We hypothesized that a multifunction service would improve operational efficiency and generate meaningful cost savings. We performed a single-center, retrospective review of Team 2 activities from January 21, 2023, to April 21, 2025, at Jacksonville campus of Mayo Clinic Florida, encompassing 400 consult encounters across 7 multifunction service domains. We determined cost savings using a time-driven, activity-based costing method, which estimated bed-day savings using a $2500/day cost and average 2-day hospital length-of-stay reduction with earlier intervention.

During the study period, a total 200 LPs were performed, creating an estimated cost savings of $1 million. Team 2 completed around 100 LPs/year vs 23/year with the previous model, reducing length of stay by 2 days per LP (∼$5000/patient; ∼$500,000/year). This led to earlier postoperative discharges, as early as the day of the LP in some cases. These collective functions similarly streamlined care pathways, fostering bed availability, and led to earlier discharge of patients needing LP consult and those in the primary postoperative NeuroICU using an early discharge process.

A multifunctional NeuroICU day team yielded measurable throughput gains and substantial direct cost savings, as well as added team operational resilience.