Before the move, the MICU was staffed eight hours daily, seven days a week, with physicians who specialize in intensive and critical care medicine. It had a nursing ratio of one nurse for every 1.7 patients and the physician staffing level was consistent with the recommendations of the Leapfrog Group.
After the move, UMMC's MICU adopted 24-hour critical care physician coverage, as recommended by the American College of Critical Care Medicine. Clinical pharmacists evaluated patients daily and the number of respiratory therapists was increased.
This was the first study to look at the impact of increasing staffing levels to meet the ACCCM guidelines, according to Giora Netzer, MD, assistant professor of medicine and epidemiology and preventive medicine at the University of Maryland School of Medicine and the principal investigator. "We found that taking the staffing to an even higher level may save even more lives."
The length of stay in the MICU increased slightly after the changes, from a median 2.4 to 2.7 days, but there was no change in total hospital length of stay. MICU costs rose post-change, from a median of $4,071.10 per patient admission to $6,232.20. The total per admission hospital variable costs also increased from median $11,819.90 to $13,178.90.