(392) Establishing Multidisciplinary Tele-Rounds in a Critical Care Unit

Introduction: The implementation of electronic intensive care units (eICU), and critical care-trained pharmacists within eICUs, has increased accessibility of drug information resources in a time of heightened demand for intensive care services. While the use of eICUs has continued to grow in the last several years, the impact of establishing telemedicine rounds is not well described. The purpose of this pilot was to integrate an eICU pharmacist into an on-site multidisciplinary team and assess the impact on medication management.

Methods: In March 2024, a critical care-trained eICU pharmacy specialist began virtually attending multidisciplinary rounds for a 12-bed critical care unit in a community hospital. Two-way audio communication was established through secure hospital phones or Zoom application conferencing. Medication recommendations were provided to on-site intensivists, pulmonologists, infectious disease physicians, and other consultants during and after rounds. The primary outcome was number and type of pharmacist interventions provided from the eICU.

Results: Over a 4-month period, 1,834 interventions were provided by the eICU pharmacy specialist to the on-site multidisciplinary team with a 96.9% acceptance rate. Two hundred thirty-six patients were included with an average of 7.8 medication-related interventions per patient. Recommendations provided focused on antimicrobial stewardship (27.3%), glycemic management (9.2%), initiating therapy (20.8%), discontinuing therapy (14.6%), and anticoagulation services (7.4%). Other notable interventions consisted of virtual code response, parenteral nutrition management, and sedation-related recommendations.

Conclusions: The collaboration between on-site medical teams and eICU pharmacy specialists can enable specialized medication-related interventions to impact critically ill patients. Virtually integrating an eICU pharmacist into the multidisciplinary team can optimize medication regimens and increase accessibility to pharmacy clinical services.