• Daniel L Lemkin, Benoit Stryckman, Joel E Klein, Jason W Custer, William Bame, Louise Maranda, Kenneth E Wood, Courtney Paulson, and Dezman Zachary D W ZDW Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: zdezman@som.umaryland.edu..
• Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
• J Crit Care. 2020 Jun 1; 57: 246-252.

PurposeTo measure how an integrated smartlist developed for critically ill patients would change intensive care units (ICUs) length of stay (LOS), mortality, and charges.Materials And MethodsPropensity-score analysis of adult patients admitted to one of 14 surgical and medical ICUs between June 2017 and May 2018. The smart list aimed to certain preventative measures for all critical patients (e.g., removing unneeded catheters, starting thromboembolic prophylaxis, etc.) and was integrated into the electronic health record workflows at the hospitals under study.ResultsDuring the study period, 11,979 patients were treated in the 14 participating ICUs by 518 unique providers. Patients who had the smart list used during ≥60% of their ICU stay (N = 432 patients, 3.6%) were significantly more likely to have a shorter ICU LOS (HR = 1.20, 95% CI:1.0 to 1.4, p = 0.015) with an average decrease of -$1218 (95% CI: -$1830 to -$607, P < 0.001) in the amount charged per day. The intervention cohort had fewer average ventilator days (3.05 vent days, SD = 2.55) compared to propensity score matched controls (3.99, SD = 4.68, p = 0.015), but no changes in mortality (16.7% vs 16.0%, p = 0.78).ConclusionsAn integrated smart list shortened LOS and lowered charges in a diverse cohort of critically ill patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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