Communication facilitator in ICU economically feasible

(HealthDay)—Staffing the intensive care unit (ICU) with a communication facilitator is economically feasible, according to research published in the December issue of the Annals of the American Thoracic Society.

Nita Khandelwal, M.D., from Harborview Medical Center in Seattle, and colleagues examined the economic feasibility of staffing ICUs with a communication facilitator using data from a randomized trial. One hundred thirty-five patients were admitted to the ICU at a single hospital with predicted mortality of ≥30 percent and a surrogate decision maker. The authors examined the differences in ICU total and direct variable costs for intervention and control patients.

The researchers observed a reduction in total and average daily ICU costs with the intervention (P = 0.02 and 0.006, respectively). Families of survivors spent less time per encounter with facilitators than families of decedents (mean, 25 versus 36 minutes), despite more contacts. After incorporating facilitator costs, simulation projected maximal weekly savings with a 1.0 full-time equivalent facilitator and 15 percent predicted ICU mortality (total weekly ICU savings of $58.4 k; weekly direct variable savings, $5.7k).

"Adding a full-time trained communication facilitator in the ICU may improve the quality of care while simultaneously reducing short-term (direct variable) and long-term (total) health care costs," the authors write. "This intervention is likely to be more cost-effective in a lower-mortality population."

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