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.
Authors
- Laura Andreea Ghenciu (ORCID: https://orcid.org/0000-0002-5326-5438)
- Alexandru Florin Rogobete (ORCID: https://orcid.org/0000-0003-1286-4431)
- Marius Păpurică (ORCID: https://orcid.org/0000-0002-4065-3650)
- Stelian Adrian Rițiu (ORCID: https://orcid.org/0000-0002-8751-6813)
- Emil Robert Stoicescu (ORCID: https://orcid.org/0000-0003-4620-3340)
- Daiana Toma
- Dorel Săndesc (ORCID: https://orcid.org/0000-0003-0349-8257)
- Claudiu Bârsac (ORCID: https://orcid.org/0000-0001-7591-7241)
- Ovidiu Horea Bedreag (ORCID: https://orcid.org/0000-0002-3432-9168)
- Adelina Băloi
- Carmen Alina Gizea
Institutions
- Spitalul Clinic Judeţean de Urgenţă "Pius Brînzeu" Timişoara (RO)
- Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
Publication Details
- Journal
- Journal of Clinical Medicine
- Published
- 2025-12-18
- DOI
- https://doi.org/10.3390/jcm14248964
- Primary Topic
- Sepsis Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00