SHM Converge Scientific Abstract ePoster Gallery-Cost-Effectiveness of Improving Appropriate Use of Peripherally Inserted Central Catheters

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This study evaluated whether a multi-hospital quality improvement (QI) program to improve appropriate use of peripherally inserted central catheters (PICCs) was cost-effective. The program was implemented across 35 Michigan hospitals from 2015 to 2021 and involved 43,422 adult PICCs total: 17,418 before the intervention and 26,004 during the intervention period.<br /><br />The QI initiative aimed to increase appropriate PICC use in three ways: more single-lumen PICCs, more short-duration PICCs (5 days), and fewer PICCs placed in patients with stage 3B chronic kidney disease. After implementation, all three measures improved: single-lumen PICC use increased, short-term PICCs increased, and PICCs in patients with kidney disease decreased.<br /><br />The study also examined PICC-related complications, including central line-associated bloodstream infection (CLABSI), venous thromboembolism (VTE), and catheter occlusion. Using segmented logistic regression, the authors estimated that the intervention prevented 871 CLABSIs, 2,535 VTEs, and 8,743 catheter occlusions during the post-intervention period.<br /><br />Financially, the QI program cost $31.8 million over seven years. However, the estimated cost savings from prevented complications were $64.4 million, resulting in a net benefit of $32.6 million. The cost-offset per complication averted was $2,614, and the return on investment was 103 per $100 spent.<br /><br />Overall, the study concluded that a large-scale, sustained QI program can improve PICC appropriateness and produce meaningful clinical and financial benefits, making it cost-effective over time.

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David Paje

Meta Tag

Author List Amy L. McKenzie, David Paje, Elizabeth McLaughlin, Jennifer K. Horowitz, Megan Heath, Scott A. Flanders, Steven J. Bernstein, Thomas D. Leyden, Vineet Chopra

Category Research

Concept PICC Line

Concept Quality Improvement Program

Concept Appropriateness Measure

Concept Hospital

Concept Single-Lumen Catheter

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author David Paje

Track Quality Improvement

Keywords

peripherally inserted central catheters

PICC

quality improvement

cost-effectiveness

multi-hospital program

central line-associated bloodstream infection

venous thromboembolism

catheter occlusion

Michigan hospitals

return on investment

PICC Line

Quality Improvement Program

Appropriateness Measure

Hospital

Single-Lumen Catheter