Shift-Based Staffing Model Cuts Costs, Length of Stay

2011 ◽  
Vol 4 (7) ◽  
pp. 19
Author(s):  
MARY ELLEN SCHNEIDER
ICU Director ◽  
2012 ◽  
Vol 4 (1) ◽  
pp. 11-14
Author(s):  
Edwin Annan ◽  
Kristin G. Fless ◽  
Nirav Jasani ◽  
Frantz Pierre-Louis ◽  
Fariborz Rezai ◽  
...  

Background and Objectives. High-intensity ICU staffing model is associated with quality and outcome improvements. Restrictive red blood cell (RBC) transfusion strategies have been shown to have equivalent mortality to a more liberal strategy in the ICU. We examined the effect of high-intensity staffing on pretransfusion hemoglobin levels, RBC transfusion rates and length of ICU stay. Materials and Methods. The study was a retrospective chart review (n = 196) of all patients admitted to the adult medical/surgical ICU for more than 24 hours one year prior to and after institution of the high-intensity staffing model. Results. Matched for demographics and diagnosis, RBC transfusion rates pre- versus postinstitution of the high-intensity staffing model was 42% versus 27%, respectively, and pretransfusion hemoglobin levels were lower (8.94 to 7.39 g/dL). Length of stay was 4.1 days pre–high-intensity staffing and 4.0 days post–high-intensity staffing. Conclusions. High-intensity ICU staffing resulted in fewer RBC transfusions and lower transfusion thresholds. This restrictive RBC transfusion strategy had no adverse effects on patient ICU length of stay.


2018 ◽  
Vol 34 (6) ◽  
pp. 553-560
Author(s):  
Christopher M. O’Donnell ◽  
Marsha Stern ◽  
Traci Leong ◽  
Ethan Molitch-Hou ◽  
Bruce Mitchell

Little research in hospital medicine examines the effects of hospitalist continuity on patient outcomes. This study implemented a novel staffing model with approximately half of rounding teams starting their 7-day workweek on Monday and the others on Friday. Teams admitted their own patients on their first 4 days with additional nighttime admissions handed off to those teams. No admissions were given to teams on their last 3 days. Length of stay was significantly reduced from 6.34 days in 2015 to 5.7 days in 2016 ( P < .002) with a significant decrease in handoffs. There was an increase in odds ratio of death (1.37, SE = .128) with each additional hospitalist involved in a patient’s care while adjusting for year and number of patient diagnoses ( P < .001). There was no statistical difference in charges, 30-day readmissions, or mortality between years.


2001 ◽  
Vol 120 (5) ◽  
pp. A403-A404
Author(s):  
J HARRISON ◽  
J ROTH ◽  
R COHEN

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