Improving Quality of Care and Reducing Cost Burdens Through NPWT Management Automation

Background: Hospitals devote significant resources to properly manage patients prescribed Negative Pressure Wound Therapy (NPWT) utilizing the traditional system.  In the traditional system, personnel must complete manual processes and coordinate with multiple outside vendors to ensure NPWT is properly documented, billed, and available at discharge to allow transition from an inpatient device to a second outpatient device. The traditional system limits a hospital’s ability to timely discharge patients causing increases in hospital length of stay and increased cost of care. A level one trauma center recently implemented an automated NPWT inventory management system that automates manual processes and allows inpatient and outpatient care with one device using GPS and RFID enabled NPWT devices.  

Purpose: The purpose of this study was to investigate how the automated inventory management system impacted geometric length of stay and case cost for inpatient NPWT. 

Methods: This study was designed as a retrospective interrupted time series between February 2015 – August 2018. The trauma center implemented the system in February 2017 defining the pre-intervention (cases: 442) and post intervention (cases: 528) periods.  Following removal of outlier data, segmented linear regression was used to model and compare the monthly geometric length of stay, dressing changes per case, and case cost between the two periods. Significant differences were identified with the Wald test.

Results:  The system significantly reduced geometric length of stay by 1.77 day (p-vale: 0.022). Dressing changes per case reduced by 0.22 (p-value: 0.37) indicating elimination of 1 in 5 dressing changes in the post-intervention period. Average case cost reduced by $3630 (p-value: 0.057) correlating with the cost savings from reduced length of stay. 

Conclusion: These results support how automation of NPWT management and use of one device per patient improves quality of care and reduces the economic burden of NPWT on the hospital and patient.