Intensive Care Unit Initiative Tied to Lower Mortality

Mortality reduced in Michigan ICUs after implementation of quality improvement initiative

TUESDAY, Feb. 1 (HealthDay News) -- An intensive care unit (ICU) quality improvement initiative in Michigan appears to result in reduced mortality, according to a study published online Jan. 31 in BMJ.

Allison Lipitz-Snyderman, Ph.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues compared hospital admissions for patients treated in 95 study hospitals in Michigan (238,937 total admissions) with 364 hospitals in the surrounding Midwest region (1,091,547 total admissions). Their objective was to evaluate whether implementation of a comprehensive statewide quality improvement initiative, the Michigan Keystone ICU project, focused on reduction of infections, was associated with reductions in hospital mortality and length of stay for adults aged 65 years or older admitted to ICUs. The study period began two years before implementation of the initiative and ended 22 months after implementation.

The researchers found significantly greater reductions in mortality for the study group than the comparison group one to 12 months and 13 to 22 months after initiative implementation (odds ratios, 0.83 and 0.76, respectively). However, the overall trajectory of length of stay was not significantly different between the groups.

"Implementation of the Keystone ICU project was associated with a significant decrease in hospital mortality in Michigan compared with the surrounding area," the authors write. "The project was not, however, sufficiently powered to show a significant difference in length of stay."

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