Digital Transformation in Critical Care: Implications for Quality of Care, Infection Control, and Clinical Outcomes

<b>Background/Objectives:</b> Digitalization of intensive care units (ICUs) aims to enhance patient safety and efficiency through standardized documentation, real-time data integration, and clinical decision support. This study evaluated whether the implementation of a patient data management system (PDMS) was associated with improvements in quality of care, infection prevention, and patient outcomes in a trauma ICU. <b>Methods</b>: We conducted a single-center, retrospective, before-after cohort study comparing a pre-digitalization period (2021-2022) with a post-digitalization period (2025). Consecutive adult trauma ICU admissions were analyzed. The exposure was unit-wide adoption of a PDMS implemented in 2024. The primary outcome was ICU length of stay (LOS); secondary outcomes included ICU mortality, nosocomial infection rates (episodes per 1000 ICU-days), ventilation- and antibiotic-days, device utilization, and infection epidemiology. Prespecified sensitivity analyses were performed. <b>Results</b>: A total of 108 patients were included (43 pre- and 65 post-digitalization). Baseline characteristics were comparable between groups. Median ICU LOS decreased from 13.0 to 6.0 days (<i>p</i> = 0.02). Mortality declined from 18.6% to 6.2% (<i>p</i> = 0.06), and crude infection rates decreased from 42.2 to 30.8 per 1000 ICU-days (rate ratio 0.73; <i>p</i> = 0.28). Adjusted analyses showed no statistically significant differences for mortality (aOR 0.40; <i>p</i> = 0.45), infection rates (aIRR 0.88; <i>p</i> = 0.68), LOS (aRR 1.04; <i>p</i> = 0.87), ventilation-days (aRR 0.86; <i>p</i> = 0.65), or antibiotic-days (aRR 0.70; <i>p</i> = 0.30). Per-patient rates of ventilator-associated pneumonia and bloodstream infection were significantly lower after digitalization (both <i>p</i> = 0.04), and <i>Acinetobacter</i> spp. infections decreased markedly (7 to 0 cases; <i>p</i> = 0.001). Findings were consistent after exclusion of ICU stays < 24 h. <b>Conclusions</b>: ICU digitalization was associated with shorter unadjusted ICU stays and favorable trends in infection and mortality outcomes, though adjusted analyses were neutral. Larger multicenter studies incorporating device-day denominators and time-to-event analyses are needed to confirm the causal impact of digital transformation on ICU quality of care.

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Journal
Journal of Clinical Medicine
Published
2025-12-18
DOI
https://doi.org/10.3390/jcm14248964
Primary Topic
Sepsis Diagnosis and Treatment
Type
article
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article

Digital Transformation in Critical Care: Implications for Quality of Care, Infection Control, and Clinical Outcomes

Laura Andreea Ghenciu, Alexandru Florin Rogobete, Marius Păpurică, Stelian Adrian Rițiu et al.
Journal of Clinical Medicine
Sepsis Diagnosis and Treatment
article

Digital Transformation in Critical Care: Implications for Quality of Care, Infection Control, and Clinical Outcomes

Laura Andreea Ghenciu, Alexandru Florin Rogobete, Marius Păpurică, Stelian Adrian Rițiu, Emil Robert Stoicescu, Daiana Toma, Dorel Săndesc, Claudiu Bârsac, Ovidiu Horea Bedreag, Adelina Băloi, Carmen Alina Gizea
article en

Abstract

<b>Background/Objectives:</b> Digitalization of intensive care units (ICUs) aims to enhance patient safety and efficiency through standardized documentation, real-time data integration, and clinical decision support. This study evaluated whether the implementation of a patient data management system (PDMS) was associated with improvements in quality of care, infection prevention, and patient outcomes in a trauma ICU. <b>Methods</b>: We conducted a single-center, retrospective, before-after cohort study comparing a pre-digitalization period (2021-2022) with a post-digitalization period (2025). Consecutive adult trauma ICU admissions were analyzed. The exposure was unit-wide adoption of a PDMS implemented in 2024. The primary outcome was ICU length of stay (LOS); secondary outcomes included ICU mortality, nosocomial infection rates (episodes per 1000 ICU-days), ventilation- and antibiotic-days, device utilization, and infection epidemiology. Prespecified sensitivity analyses were performed. <b>Results</b>: A total of 108 patients were included (43 pre- and 65 post-digitalization). Baseline characteristics were comparable between groups. Median ICU LOS decreased from 13.0 to 6.0 days (<i>p</i> = 0.02). Mortality declined from 18.6% to 6.2% (<i>p</i> = 0.06), and crude infection rates decreased from 42.2 to 30.8 per 1000 ICU-days (rate ratio 0.73; <i>p</i> = 0.28). Adjusted analyses showed no statistically significant differences for mortality (aOR 0.40; <i>p</i> = 0.45), infection rates (aIRR 0.88; <i>p</i> = 0.68), LOS (aRR 1.04; <i>p</i> = 0.87), ventilation-days (aRR 0.86; <i>p</i> = 0.65), or antibiotic-days (aRR 0.70; <i>p</i> = 0.30). Per-patient rates of ventilator-associated pneumonia and bloodstream infection were significantly lower after digitalization (both <i>p</i> = 0.04), and <i>Acinetobacter</i> spp. infections decreased markedly (7 to 0 cases; <i>p</i> = 0.001). Findings were consistent after exclusion of ICU stays < 24 h. <b>Conclusions</b>: ICU digitalization was associated with shorter unadjusted ICU stays and favorable trends in infection and mortality outcomes, though adjusted analyses were neutral. Larger multicenter studies incorporating device-day denominators and time-to-event analyses are needed to confirm the causal impact of digital transformation on ICU quality of care.

Journal of Clinical MedicineVol. 14(24)
Spitalul Clinic Judeţean de Urgenţă "Pius Brînzeu" Timişoara (RO), Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
Openalex Percentile: Top 47%
Sepsis Diagnosis and Treatment
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