740: COMPARISON OF CRITICAL CARE PHARMACIST WORKLOAD AND CLINICAL OUTCOMES AT AN ACADEMIC HOSPITAL

Introduction: An ideal Critical care pharmacist (CCP)-to-patient ratio has not been established, and existing literature has aimed to explore the relationship between pharmacist workload and its impact on patient-centered outcomes in the ICU. The purpose of this study is to further characterize the association between CCP workload and patient-centered outcomes following acute care practice model changes at an academic hospital. Methods: A single-center, observational, cohort study was conducted at a 333-bed academic hospital in Indianapolis, Indiana. This institution’s pharmacy department underwent practice model changes in February 2024. The pre-acute care practice model (ACPM) group occurred from August 2023 to January 2024, and the post-ACPM group occurred from October to December 2024. The primary outcome was in-hospital mortality. Patients were included in the study if they were admitted to an ICU service during the prospective study period. Results: We observed a lower in-hospital mortality, in the pre-ACPM group compared to the post-ACPM group (11% vs. 17%; p < 0.001). We also observed a shorter median initial ICU length of stay (LOS) in the pre-ACPM group [2 (1 -4) vs. 3 (2 – 7) days; p < 0.001) as well as total mechanical ventilation duration [2 (1 – 6) vs. 3 (2 – 8); p < 0.001]. We observed a correlation between mortality and MRC-ICU score [correlation coefficient (r) = 0.407, P < 0.001] and a novel ICU clinical score (r= 0.3, p < 0.001). Conclusions: This study further characterizes the changes in CCP-to-patient ratios and associated clinical outcomes following pharmacy department practice model changes in adult ICU patients. We observed lower in-hospital mortality, initial and total ICU LOS, and mechanical ventilation duration in the pre-ACPM group, while observing no difference in Medication Regimen Complexity- ICU (MRC-ICU) scores, in the setting of a similar CPP-to-ICU-patient ratio and a higher CCP-to-total-patient ratio. The study also found a correlation between a novel ICU clinical score and outcomes of mortality, ICU LOS, duration of mechanical ventilation, delirium incidence, MRC-ICU score, and SOFA scores. This may demonstrate clinical utility of this novel ICU clinical scoring tool for prioritizing clinical patient review when integrated into the electronic medical record.