{Reference Type}: Journal Article
{Title}: Intensive care unit improves dialysis care quality while reducing costs.
{Author}: Nichols TG;Doman D;Mullen S;Ramaiyah S;Rowe S;D'Alessandri-Silva CJ;Dunning S;
{Journal}: J Med Econ
{Volume}: 27
{Issue}: 1
{Year}: 2024 Jan-Dec
{Factor}: 2.956
{DOI}: 10.1080/13696998.2024.2357038
{Abstract}: <B>UNASSIGNED: </B>The current report details transition of outsourced conventional dialysis therapy in the ICU services to an in-house prolonged intermittent renal replacement therapy (PIRRT) service model as a quality improvement project using the Tablo Hemodialysis System, Outset Medical, Inc. The goals were aimed at maintaining or improving clinical outcomes, while also reducing dialysis-related nursing staff burden and dialysis-related treatment costs.<BR><B>UNASSIGNED: </B>A descriptive comparative analysis was conducted of renal replacement therapy (RRT) of ≥6 hours in duration performed in the 1 year prior and 1 year after the ICU's in-house program launch using a PIRRT model including sequential 24-h treatments when medically necessary.<BR><B>UNASSIGNED: </B>Overall, there were 145 intensive care unit (ICU) stays among 145 patients with 13,641 h of conventional ICU dialysis in the year prior to program transition. In the year post, there were 116 ICU stays among 116 patients with 5,098 h of PIRRT. By employing a PIRRT and sequential 24-h treatment strategy vs. the prior outsourced model, the mean dialysis treatment hours per patient were reduced (Pre, 94.1 h with 214 treatment starts; Post, 43.9 h with 370 treatment starts), increasing ICU nurse productivity by 50.2 h per patient. Overall, ICU length of stay and ICU mortality declined post-service transition by 4.8 days and 9.8 percentage points (pp), respectively, overall, and in the non-COVID subset by 1.6 days and 3.1 pp, respectively.<BR><B>UNASSIGNED: </B>Insourcing RRT with an innovative technology that can provide both PIRRT and 24-h sequential treatments can maintain or improve clinical outcomes in critically ill patients requiring RRT in the ICU, while reducing dialysis-related costs.