PT  - JOURNAL ARTICLE
AU  - Fajun Wang
AU  - Amitha Avasarala
AU  - Nizari Pandya
AU  - Karan Panchal
AU  - Darby Scarantine
AU  - Allan David
AU  - Jeniffer Bozogan
AU  - Jennifer Arendas
AU  - Julia Maseth
AU  - Megan Lowman
AU  - Samantha Zych
AU  - Jonathan Bishop
AU  - Firas Abdulmajeed
TI  - Impact of respiratory therapists-driven assess-and-treat protocol on unplanned adult neurovascular ICU readmissions: a quality improvement initiative
AID  - 10.1136/bmjoq-2022-001816
DP  - 2022 May 01
TA  - BMJ Open Quality
PG  - e001816
VI  - 11
IP  - 2
4099  - http://bmjopenquality.bmj.com/content/11/2/e001816.short
4100  - http://bmjopenquality.bmj.com/content/11/2/e001816.full
SO  - BMJ Open Qual2022 May 01; 11
AB  - ICU readmission is associated with increased mortality, resource utilisation and hospital expenditure. In the general population, respiratory-related event is one of the most common causes of unexpected ICU readmission. Patients with neurological deficits faced an increased risks of ICU readmissions due to impaired mentation, protective reflexes and other factors. A retrospective review revealed that the leading cause of unexpected ICU readmissions in adult neurovascular patients admitted to our hospital was respiratory related. A respiratory therapists-driven assessment-and-treat protocol was developed for proactively assessing and treating adult neurovascular patients. On-duty respiratory therapists assessed all neurovascular patients on admission, assigned a respiratory severity score to each patient and then recommended interventions based on a standardised algorithm.Our quality improvement initiative had no effect on the rate of unexpected ICU readmissions in adult neurovascular patients. When compared with the baseline population, patients enrolled in the intervention group were significantly older ((79, 68–85 years) vs (71, 56–81 years)), but they spent comparable amount of time in the ICU (4.5 vs 4 days, p=0.42). When the respiratory severity score was trended in the intervention group, patients demonstrated significant improvement in their respiratory function, with a greater proportion of patients scoring in the minimal and mild categories and smaller proportion in the moderate category (p<0.01).Data are available on reasonable request.