753: Surgical-Critical Care Quality Improvement Program: A New Efficient, Prospective Resource

Introduction: Level 1 Trauma Centers often utilize combined surgery and trauma ICUs (STICU) to care for a large variety of surgical services. Quality care requires rapid assessment and outcome metrics to ensure optimal care in clinically diverse populations. Trauma centers are mandated to provide registry resources that include critical care data, but for trauma patients only. Unfortunately, limited resources often exist for collecting similar data on non-trauma critically ill surgical patients. Our newly combined STICU, established after separating from a MICU, required creation of a new quality improvement process (S-CCQIP). Methods: A 26-point performance improvement checklist was developed and tested specifically for our 12 bed STICU. Similar metrics (16/26 points) from a verified national trauma registry were utilized. Prospective data was collected daily by primary providers during rounds for each patient; completion confirmed in PM by attending surgical intensivist. Process was refined during study period to improve accuracy and efficiency. STICU census list from EHR utilized to complete data. Results: 1107 checklists completed for 390 patients during a 6-month initial trial period (Feb-Jul 2024). Initial checklist compliance was 75%, with improvement to 97% after adjustments in checklist delivery, team workflow and improved monitoring. 11 surgical specialties represented in the new registry (42% trauma, 37% gen surg, 21% other). Leading monthly data points noted were respiratory failure (28), severe sepsis (16), AKI (14), unplanned admission (14), malnutrition (10), unplanned return to OR (8), delirium (8), and unplanned intubation (6). Individual patient daily data entry time was < 3 minutes. Final registry data entry required.25 FTE/week. Conclusions: Surgical-trauma ICUs face unique challenges to meet the need for essential quality improvement programs for non-trauma patients due to lack of a mandate and limited resources. This study validates the efficacy of a cost-effective and time efficient quality improvement process. Our sustainable critical care registry presents opportunities for quality improvement previously unavailable at our Level 1 Trauma Center. Maintaining dedicated trained registry personnel remains the greatest challenge to our new quality program.