B55-17 Improving Daily Spontaneous Awakening and Breathing Trial Compliance Through Multidisciplinary Respiratory Therapy Rounds in the Medical ICU

Abstract Introduction Daily spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT) are evidence-based interventions that can shorten ventilator duration, ICU length of stay and in some cases lower mortality. Despite strong supporting data, adherence to these protocols often remains suboptimal due to workflow fragmentation and limited interdisciplinary communication. At Mount Sinai Morningside (MSM), SAT and SBT compliance averaged 46 % and 75 %, respectively in 2024, prompting a unit-based quality-improvement (QI) initiative to enhance multidisciplinary coordination and engagement. Methods This single-center QI initiative was conducted in the Mount Sinai Morningside (MSM) Medical ICU, a 24-bed medical ICU within an academic tertiary care center, and included all mechanically ventilated adult patients between January and September 2025. Baseline compliance in January 2025 was 34 % for SAT and 77 % for SBT. Three key interventions were introduced: (1) Respiratory therapy (RT) multidisciplinary rounds beginning February 2025, held daily at 8 AM and attended by the ICU attending or fellow, RT, and charge nurse; (2) Standardization of timing for paired SAT/SBT, designating 8 AM for SAT initiation and 8:30 AM for SBT, to improve coordination and minimize overnight variability; and (3) Nursing education and reinforcement, initiated through a one-hour unit-council session and ongoing reminders during morning huddles. Compliance was defined as the proportion of ventilated ICU episodes (≥ 1 full day on mechanical ventilation) with daily SAT or SBT documentation—either performed or with an appropriate reason for deferral—on all but the first ventilator day. Data were collected retrospectively via electronic chart review. Results Following implementation, SAT compliance improved from 34 % (January 2025) to 69 % (September 2025), while SBT compliance increased from 77 % to 86 %. Improvements were temporally associated with the initiation of multidisciplinary rounds and reinforced nursing education. Conclusions Structured multidisciplinary RT rounds with standardized timing and focused nursing engagement were associated with marked improvement in daily SAT/SBT compliance in a single medical ICU. This finding is consistent with evidence that coordinated, multidisciplinary team-based approaches can facilitate adherence to ventilator liberation protocols. Enhanced compliance with SAT/SBT protocols lays the foundation for evaluating downstream outcomes such as ventilator days, tracheostomy rates, and ICU length of stay. This abstract is funded by: None