A set of nurse/respiratory therapist-driven algorithms developed by a multidisciplinary team with the goal of "liberating" mechanically ventilated pediatric patients more rapidly from the ventilator resulted in sustained improvement over a 47-month period. The difference between expected and observed billed ventilator hour totals was over 22,000 hours (475 hours per month), a 17.5% reduction, which was significant at the P =.03 level by multiple linear regression analysis. Length of stay and mortality rate were unchanged. This difference represents a measure of the unrecognized cost of a nonstandardized approach to the weaning process. This reports reviews this team's success factors and hurdles and offers practical suggestions for pediatric surgeons interested in leading quality improvement initiatives.
Copyright 2002 by W.B. Saunders Company