Students Research in Progress
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Introduction: The relationship between critical care pharmacist (CCP) workload and patient outcomes has not been rigorously evaluated. Characterization of medication regimen complexity (MRC) and CCP workload could potentially improve patient outcomes and optimize resource allocation.
Research Question or Hypothesis: What is the current MRC and CCP workload in the Surgical ICU (SICU) of a large academic medical center?
Study Design: Site-specific subset analysis of a large, multicenter, prospective, observational cohort of the ongoing Optimizing Pharmacist Team-Integration for ICU Patient Management (OPTIM) study.
Methods: The OPTIM study includes 100 consecutive days of prospective patient enrollment, collection of pharmacist workload indices, and evaluation of patient outcomes. All patients admitted to two SICU rounding services covered by two CCPs from September through December 2023 were included in this study if their ICU stay was greater than 24 hours.
Results: Two hundred seventy-nine patients were included. Median age was 63.8 years, 20.5% of patients died prior to hospital discharge, 42% experienced delirium, 45% received vasopressor support, and 41.6% received mechanical ventilation. Median Sequential Organ Failure Assessment (SOFA) score on admission was 5 (IQR 2-8) and the MRC-ICU score was 8 (IQR 5-14). Each CCP covered a mean of 9 patients per day, averaging 2.4 new patients. Clinical coverage was provided by both, one, and no CCPs for 35%, 24%, and 40% of study days. CCPs rounded on a lower percentage of patients when covering two versus one clinical service (52.6% vs 100%) and newly admitted patients were less likely to be reviewed by a CCP within 24 hours when admission occurred on a weekend (25% vs 76.8%). There were learners on service for 20% of the study period.
Conclusion: These preliminary results indicate a high severity of illness within our SICU with opportunities to improve clinical coverage.
Presenting Author
Kathryn Connor Pharm.D.University of Rochester Medical Center-Strong Memorial Hospital
Authors
Emily Austin Pharm.D. Candidate
SJF
Sam DeWitt Pharm.D. Candidate
SJF
Makenna Moll Pharm.D.
SJF
Stephen Rappaport Pharm.D.
The University of Rochester Medical Center
Marinna Raqueno Pharm.D. Candidate
SJF
Laura Witt Pharm.D. Candidate
SJF