Department Blog

Posted 10/23/2019 by Deborah Stein

Integrated smart list shortens length of stay and lowers charges in critically ill ICU patients

Daniel L. Lemkin, MD, Benoit Stryckman, MA, and Zachary D.W. Dezman, MD, among other authors, have an in-press article titled “Integrating a safety smart list into the electronic health record decreases intensive care unit length of stay and cost” prepublished online in the Journal of Critical Care.

Dr. Dezman writes, "This paper shows the impact of a preventative-care checklist for critically ill patients. It reminds physicians to administer prophylactic medications and remove lines and catheters as soon as it is safe for patients. The checklist will dynamically update to reflect the patient's status (e.g., it won't ask the physician to remove a central line that was already removed). It was designed to work in any type of critical care unit (adults or children, surgical and medical patients) and is integrated into our EHR.

The more that the clinicians used the checklist, the more likely the patient was to be downgraded sooner from the ICU compared to regular care. There was a decrease in days where the patient was on a breathing machine and a trend towards fewer cases of ventilator-associated pneumonia. There was a corresponding decrease in costs. There was no change in mortality associated with checklist use.

We are currently working towards getting more clinician engagement and measuring the impact of the checklist as it is used more and more."