• Michael Nurok, Jonathan Warsh, Todd Griner, Mayumi Kharabi, Joseph Castongia, Cali Overbeck, Lisa Krueger, Bernice Coleman, Danny Ramzy, Joshua Chung, Alice Chan, Eric Ley, Sindhu Kubendran, Neil Parrish, Zhe Yu, Michael Langberg, Stuart Finder, Bradley T Rosen, Robert S Kaplan, Harry Sax, and Francisco Arabia.
• From the Department of Surgery, Cedars-Sinai Heart Institute, Los Angeles, California.
• Anesth. Analg. 2019 Mar 1; 128 (3): e38-e41.

AbstractWe describe a quality improvement initiative aimed at achieving interdisciplinary consensus about the appropriate delivery of extracorporeal membrane oxygenation (ECMO). Interdisciplinary rounds were implemented for all patients on ECMO and addressed whether care was consistent with a patient's minimally acceptable outcome, maximally acceptable burden, and relative likelihood of achieving either. The rounding process was associated with decreased days on venoarterial ECMO, from a median of 6 days in 2014 (first quartile [Q1]-third quartile [Q3], 3-10) to 5 days in 2015 (Q1-Q3, 2.5-8) and in 2016 (Q1-Q3, 1-8). Our statistical methods do not allow us to conclude that this change was due to our intervention, and it is possible that the observed decreases would have occurred whether or not the rounding process was implemented.

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