Preventing adverse events (not only infections) in ventilator-dependent patients reduced length of stay from 20 to 15 days and costs form $72,000 to $58,000 (42).
Guideline implementation programs that require the intervention of an infectious disease consultant, a bacteriologist or a pharmacists would be more costly. It must be noted that studies of interventions to improve the appropriate use of antiinfectious agents or to reduce the use of vancomycin in the hospital have not estimated the cost of running the programs (41,43). The same can be said of the quality assurance program to reduce adverse events in ventilator-dependent patients. This program has required ‘daily collaborative bedside rounds, monthly meetings, and implementation of numerous guidelines and protocols’, none of which were costed (42). Although it is likely that reductions in inappropriate drug use and ICU length of stay will offset the additional cost of hiring consultants, data should be provided if intensivists are to convince hospital administrators and payors.
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