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Abstract Details

Utilization of systematic safety checklists to improve length-of-stay, infection rates, preventable complications and mortality at the Neurointensive Care Unit of the Baylor Saint Luke’s Medical Center: A quality improvement study.
Practice, Policy, and Ethics
P9 - Poster Session 9 (12:00 PM-1:00 PM)
7-010
To evaluate the efficacy of implementing systematic safety checklists within the Neurointensive Care Unit (NICU) at the Baylor St. Luke’s Medical Center (BSLMC). 
The care of critically ill neurological patients requires careful balancing of cerebral and other multi-systemic priorities. A systematic, multidisciplinary approach is essential to avoid potential complications.  The implementation of structured and systematized safety checklists can help avoid preventable complications, as well as improve intensive care unit length of stay (ICU-LOS), morbidity, mortality and overall NICU quality of care.
This is a quality and improvement project and follows a PDSA (Plan-Do-Study-Act) approach. Our current NICU database will be used for baseline comparison on outcome measures (morbidity, mortality and ICU-LOS). A safety checklist that includes items such as: medication reconciliation, thromboembolic prophylaxis, glycemic control, daily breathing trial, feeding, catheter duration monitoring and antibiotics de-escalation, among others; will be implemented during daily patient rounds and its completion will be attested on the clinical note. Monthly compliance audits of the safety checklists will be conducted. Infection-rates, mortality and ICU-LOS will be assessed every 3 months until completion of the project and outcome measures before and after the intervention will be compared. This project is funded by the Accelerating Clinical Excellence (ACE) Grants in collaboration with BSLMC.
Currently our NICU has a range of 40 to 60 admissions per month with a median ICU-LOS of 3 days. All the patients admitted to the NICU will be eligible for the application of safety checklists. After 1 year of execution of this project, we expect to reduce our ICU-LOS, infection rates, in-unit preventable complications and mortality by at least 30 %.
The implementation of standardized, patient-centered safety checklists in the neurocritical care setting might be a helpful tool to improve overall NICU performance and quality of care measurements.
Authors/Disclosures
Cesar E. Escamilla-Ocanas, MD
PRESENTER 		Dr. Escamilla-Ocanas has nothing to disclose.
Gabriel Torrealba Acosta, MD (Duke University Medical Center) Dr. Torrealba Acosta has nothing to disclose.
Mohammad I. Hirzallah, MD (Baylor College of Medicine) Dr. Hirzallah has nothing to disclose.
Eric Bershad, MD (Baylor College of Medicine) Dr. Bershad has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various.
Chethan P. Venkatasubba Rao, MD (Baylor College of Medicine) Dr. Venkatasubba Rao has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Maestro Inc.
Rahul Damani Rahul Damani has nothing to disclose.