1238 Systematic Screening and Identification of Obstructive Sleep Apnea in Hospitalized Patients

Abstract Introduction Undiagnosed obstructive sleep apnea (OSA) in hospitalized patients is a significant contributor to adverse outcomes, including hospital readmissions. To address this, a systematic inpatient sleep screening program was implemented across the Hackensack Meridian Health system in October 2021. The program utilized an Electronic Medical Record (EMR)-integrated screening tool to identify patients meeting high-risk criteria. Patients identified by the tool, or referred directly by their primary medical team, underwent an evaluation by a specialized sleep Advanced Practice Nurse (APN) who determined the need for further diagnostic testing. This study aimed to evaluate the feasibility and outcomes of this large-scale program. Methods The program was implemented at five hospital sites. Registered Polysomnographic Technologists (RPSGTs) identified high-risk inpatients. These patients then underwent an evaluation by a specialized sleep Advanced Practice Nurse (APN), who determined the need for further outpatient diagnostic testing. Diagnostic options included either a home sleep apnea test (HST) or in-lab polysomnography (PSG). All patients who completed a sleep study were subsequently contacted to schedule an outpatient follow-up for treatment and management. Results Widespread adoption of the program was achieved at each site. Key to the success was engagement of the inpatient sleep team with the inpatient teams at each site. Program success was driven by acceptance from patients and inpatient medical teams, emphasizing a clear clinical need. Thorough patient education and consistent engagement between inpatient sleep teams and hospital providers was essential. Conclusion We demonstrated the successful implementation and feasibility of a large-scale, multi-site inpatient OSA screening program. This model can effectively address the substantial underdiagnosis of OSA in high-risk hospitalized populations, likely improving patient outcomes. Systematic assessment of this program is warranted including the characteristics of patients recommended for sleep studies (including diagnostic yield), and readmission rates among patients who completed the program. Support (if any)