Back to 2014 Annual Meeting Abstracts

BACKGROUND:
Our hospital’s initial NSQIP data revealed major opportunities to improve outcomes among post-operative venous thromboembolism (VTE) and pulmonary complications (pneumonia, unplanned intubation, and ventilator support > 48 hours). In response, a multidisciplinary pulmonary care and mobilization program (“ICOUGH”) and an electronic VTE risk-stratification and prophylaxis system (“Caprini”) were implemented. We sought to estimate the financial impact of these initiatives following declines in complication rates in these four measured categories.
METHODS:
NSQIP and hospital record data from July 2008 to June 2013 were used to estimate the total number of pulmonary and VTE complications among general and vascular surgery patients, before and after implementation of the ICOUGH and Caprini initiatives. Cost-per-case estimates of these complications were obtained from the NSQIP Return On Investments Calculator and adjusted for inflation into 2013 dollars using the consumer price index medical services bundle.
RESULTS:
The two-year pre-intervention (2008-2010) and post-intervention (2011-2013) estimated costs of complications decreased for pneumonia ($2,017,061 vs $1,081,085), unplanned intubation ($1,363,497 vs $667,225), ventilator support greater than 48 hours ($2,268,438 vs $1,426,093), and DVT/PE ($1,033,157 vs 308,500). Allowing for the cost of NSQIP participation and the estimated cost of program implementation, the total two-year cost savings were over $2,000,000.
CONCLUSIONS:
The ICOUGH and Caprini programs have successfully reduced the incidence of pulmonary and VTE complications with significant financial savings, despite inherent costs of implementation and NSQIP participation.