Resource Optimization in the Intensive Care Unit Setting: A Staff Education and Scheduling Pilot Study to Improve Treatment Decisions and Staff Satisfaction
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Enrollment
- 73
- Primary Endpoint
- ICU Quality Metric 1: Ventilator Associated Pneumonia
Study Overview
Brief Summary
The purpose of the study is to facilitate cost-effective, high quality care within the the ICUs of two Ottawa teaching hospitals through educational workshops and nurse scheduling optimization.
Detailed Description
This intervention pilot study has been developed for Intensive Care Unit (ICU) physicians and nurses by the Resource Optimization Network (RON) for implementation in The Ottawa Hospital (TOH) Civic Campus and the Montfort Hospital. The intervention targets ICU staff and is designed to reduce overall costs associated with ICU health care service delivery and improve staff satisfaction through reducing stress and associated burnout without sacrificing quality of care and patient outcomes. The intervention involves two components that (a) build ICU staffs' (i.e. physicians and nurses) knowledge to facilitate cost-effective and evidence-based decision making about patient care (including tests, treatments, and procedures); and (b) optimize nurse scheduling to ensure the presence of the appropriate number of nurses per shift, thereby reducing stress, burnout and limiting the need for overtime. To evaluate the impact of the intervention, a pre/post-intervention design will be employed, with a 3-month pre-intervention period, followed by a 6-month intervention period and a 3-month post-intervention period.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Employees aged 18 year and older who provide direct patient care in the ICU at the Civic Campus of the Ottawa Hospital or the Montfort Hospital as physicians, nurses, or allied health professionals (e.g., respiratory therapists, occupational therapists).
Exclusion Criteria
- Not provided
Arms & Interventions
ICU Staff
The study group is composed of ICU care providers at the Ottawa Hospital Civic campus and the Montfort Hospital, including intensivists, fellows, nurses and allied health professionals. The study site participant breakdown is approximately 58 TOH staff respondents and 15 Montfort respondents.
Intervention: Educational Workshop (Behavioral)
ICU Staff
The study group is composed of ICU care providers at the Ottawa Hospital Civic campus and the Montfort Hospital, including intensivists, fellows, nurses and allied health professionals. The study site participant breakdown is approximately 58 TOH staff respondents and 15 Montfort respondents.
Intervention: Optimizing Staff Scheduling (Behavioral)
Outcomes
Primary Outcomes
ICU Quality Metric 1: Ventilator Associated Pneumonia
Time Frame: 12 months
This outcome will be included to evaluate the quality of ICU patient care during the study period. The number of patients who develop ventilator associated pneumonia will be collected from the TOH Data Warehouse and Montfort's Department of Archives and Decision Support.
ICU Quality Metric 2: Central Line Infections
Time Frame: 12 Months
This outcome will be included to evaluate the quality of ICU patient care during the study period. The number of patients who develop central line infections will be collected from the TOH Data Warehouse and Montfort's Department of Archives and Decision Support.
ICU Quality Metric 3: C. difficile
Time Frame: 12 Months
This outcome will be included to evaluate the quality of ICU patient care during the study period. The number of patients who develop C. difficile infections will be collected from the TOH Data Warehouse and Montfort's Department of Archives and Decision Support.
ICU Costs
Time Frame: 12 months
Case costing will be used to determine the costs associated with ICU care during the study period, including: a) ICU total costs; b) ICU direct costs (i.e., all expenses to the hospital with fee codes linked to patient chart); c) ICU indirect costs (i.e., any overhead operational fees associated with service provided to patient); d) ICU cost/patient.
ICU Quality Metric 4: Early Mobilization
Time Frame: 12 Months
This outcome will be included to evaluate the quality of ICU patient care during the study period. The number of patients who receive early mobilization will be collected from the TOH Data Warehouse and Montfort's Department of Archives and Decision Support.
Secondary Outcomes
- ICU Medical Procedures 2: Mechanical Ventilation(12 Months)
- Rate of ICU Staff Absenteeism(12 Months)
- ICU Medical Procedures 1: Albumin Use(12 Months)
- ICU Patient Outcomes 2: Patient Deaths(12 Months)
- ICU Medical Procedures 3: Chest Radiographs(12 Months)
- ICU Medical Procedures 4: Red Blood Cell Transfusions(12 Months)
- Staff Stress Levels and Burnout 1(12 months)
- Staff Stress Levels and Burnout 2(12 months)
- ICU Patient Outcomes 1: Length of Stay(12 Months)
- ICU Patient Outcomes 3: Perceived Quality of Care(12 Months)
- Staff Demographic Variable Collection 2(12 months)
- Stakeholder perceptions(12 Months)
- Staff Demographic Variable Collection 1(12 months)
Investigators
Kwadwo Kyeremanteng
Principal Investigator
Ottawa Hospital Research Institute