A Cost Containment Protocol That Reduces Neurosurgical Patient Length of Stay and Is Associated With Improved Patient Outcomes: 909

INTRODUCTION: In this evolving world of health care reimbursement, certain avoidable factors such as patient length of stay (PLOS) can significantly impact hospital costs. With fewer dollars available and with an expected explosion of admissions in the coming years, hospitals will need to effectively and efficiently provide quality care. Prolonged PLOS is inevitable in some circumstances but there are ways to increase bed turnover so that more patients can be helped without the potential for negative consequences. We developed a protocol that promoted faster bed turnover and simultaneously permitted low mortality rates in our Neuroscience Intensive Care Unit (NSICU).

METHODS: 3505 patients in NSICU and general care neurosurgical units were evaluated. 1901 patients were prospectively monitored using a protocol to promote early family discussions and guardianship proceedings if needed. Outside resources were used for patients that had protracted medical courses. All...