6. Craniotomy and endovascular intracranial procedures with major complications or comorbidities: Represents 8.9 percent of the ICU reduction opportunity

7. Sepsis patients using a mechanical ventilator >96 hours: Represents 6.8 percent of the ICU reduction opportunity

8. Cardiac valve and other major cardiothoracic procedure with cardiac catheterization and major complications or comorbidities: Represents 6.8 percent of the ICU reduction opportunity

9. Cardiac valve and other major cardiothoracic procedure without a cardiac catheterization, but with complications or comorbidities: Represents 6.1 percent of the ICU reduction opportunity

10. Heart failure and shock with major complications or comorbidities: Represents 6 percent of the ICU reduction opportunity

“Spending too much time in the ICU can negatively impact patients and the bottom line, particularly in this era of value-based care payment models,” said Robin Czajka, RN, service line vice president of cost management at Premier. “Decisions around admitting patients to the ICU and how they are treated can often be subjective calls, rather than guided by evidence. While ICU optimization is no easy task, robust data and analytics can help unveil opportunities to improve care delivery and quality within this setting – ranging from identifying diagnoses with the greatest variation in outcomes to monitoring patients who no longer need ICU-level care within newly-created intermediate care settings.”

Premier also found that providers in the analysis are making progress in optimizing care, identifying a 13 percent decrease in patient days spent in the ICU across the top 10 diagnoses over the five year period. Improvements were associated with the following key best practices:

Using evidence-based practices performed collectively to tackle healthcare-associated infections (HAIs) and delirium;
Creating intermediate care settings to seamlessly provide an effective transition unit for patients who no longer require ICU-level care;
Leveraging checklists to monitor patient progress and goals; and
Multidisciplinary care team collaboration with physicians, nurses, pharmacists, residents and other members of the ICU staff.
Premier’s analysis provides a deep understanding of cost and quality trends so that providers can compare performance against peers and identify unjustified variation, as well as drill down to contributing institution-, service line- and physician-level sources.

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