Mastering the ABCDEF Bundle Is an Investment, Not an Expense

Discover the Financial Benefits
of the ABCDEF Bundle

Learn about The Financial Benefits of the ABCDEF Bundle today!

This eye-opening presentation explains how creating an Awake and Walking ICU can provide significant cost savings.

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Do you want to create an Awake and Walking ICU, but you’re afraid it’ll be too expensive?

The evidence-based practices found in the ABCDEF Bundle can provide significant financial returns, and have been shown to:

Prevent/minimize delirium
Prevent falls in the ICU
Decrease time on the ventilator
Decrease ICU readmissions by 46%
Reduce the incidence of delirium by 50%
Reduce the length of ICU and hospital stays
Decrease hospital-acquired infections by 60%
Increase patients’ chances of being discharged home by 36%

Discover What Studies Have Revealed

The ABCDEF Bundle has been shown to decrease health care costs by up to 30%.
A PAD initiative in one hospital led to a 46% decrease in sedation and analgesia use, resulting in savings of $183,216 in drug costs and $1.2 million in savings for direct hospital costs.
An estimate of the potential cost savings of implementing the practices found in the ABCDEF Bundle found that an investment of the 2023 equivalent of $114,455.85 would result in net savings of $4,916,213.94.

In a trauma ICU, the implementation of an early mobility program resulted in more than $8,000 in cost savings per patient.
Each unit increase in out of bed mobility in a medical ICU decreased time on the ventilator by 22% and time in the ICU by 5-11%.
In a CVICU, an increase in physical and occupational staffing from 2 to 4 clinicians resulted in a 3.6 day decrease in ICU length of stay.

Can Your ICU Afford Not to Master the ABCDEF Bundle?

Failing to master the ABCDEF Bundle can significantly increase health care costs in many ways, including:

Increased delirium
Increased injuries to staff
More time on the ventilator
Increased workload for staff
More hospital-acquired pressure injuries and falls
Heavier psychological burden on staff, leading to burnout

Discharges to care facilities for weeks or months of rehabilitation
More hospital-acquired infections, such as hospital and ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections

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Who Is Kali Dayton?

Kali Dayton, DNP, AGACNP, is a critical care nurse practitioner, host of the Walking Home From The ICU and Walking You Through The ICU podcasts, and critical care outcomes consultant. She is dedicated to creating Awake and Walking ICUs by ensuring ICU sedation and mobility practices are aligned with current research. She works with ICU teams internationally to transform patient outcomes through early mobility and management of delirium in the ICU.

What Kali’s Clients and Colleagues Have to Say

The service Dayton ICU Consulting provided was exceptional and above expectations. As an ICU medical director, I have had to unlearn what has been taught to us over the years and what we thought was right. When I started listening to the Walking Home From The ICU podcast, I felt profound sadness and guilt for what we did to other human beings thinking what we were doing was right.

I have changed my practice and we had Dayton ICU Consulting at our hospital in each of our intensive care units for multiple sessions. It was eye-opening for the staff, especially the bedside RNs. We have developed significant momentum, especially in our surgical and trauma ICUs where staff that were non-believers are now champions of this movement. We have done videos of patients’ experiences and plan to use them to educate new hires. I am very excited about where we have come from and expect great things.

I cannot thank Kali Dayton and our staff enough for helping us improve ICU care and experiences for our patients.

Lawrence Bistrong, MD, FCCP, Medical and Surgical Intensive Care Unit Medical Director at Mercy San Juan Medical Center

When patients are so ill that they require a ventilator in the ICU, the antiquated approach of heavy sedation and immobilization should be avoided in order to help prevent the immense burden of physical and cognitive disabilities suffered during survival.

Kali is leading ICU teams to become Awake and Walking ICUs through true mastery of the ABCDEF Bundle. I endorse her mission and look forward to the standardization of this evidence-based approach in ICUs all over the world.

Dr. Wes Ely, author of Every Deep Drawn Breath, leading founder of the ABCDEF Bundle and ICU CAM delirium screening tool, and Professor of Medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine at Vanderbilt University Medical Center

One of the most striking aspects of this initiative has been the cultural shift among physicians and nurses, which has been largely influenced by the training led by Kali Dayton. These trainings emphasize the importance of collaboration and communication within the health care team, fostering a shared commitment to patient-centered care.

As a result, clinicians are more attuned to the value of keeping patients awake and engaged, which has proven to be critical in preventing the deconditioning and delirium often associated with prolonged sedation. Moreover, the dramatic improvements in patient outcomes are evident in the reduction of complications that frequently arise in the ICU setting. With fewer ventilator days, patients are less susceptible to ventilator-associated pneumonia and other respiratory complications.

The emphasis on mobility not only accelerates recovery but also contributes to improved psychological well-being, as patients are less disoriented and more connected to their surroundings. This holistic approach to care, driven by a cultural transformation among health care providers, underscores the profound impact of mobility-limited sedation protocols on patient health and safety.

Peter Murphy, MD, FCCP, MRCPI, Professor, Assistant Dean, and Chief of Medicine at California Northstate University College of Medicine

I stumbled upon Kali’s podcast midway through my anesthesia critical care fellowship in February 2021. At our institution, I got the impression that patients in the ICU either got better on their own or had a prolonged and complicated course to LTAC or death. In her podcast, Kali explained that LTAC was rarely the outcome for patients in the Awake and Walking ICU in Salt Lake City.

Their ICU survivors hardly ever got trached, PEGed, or sent to LTAC, and literally walked out of the hospital in condition as close to their previous health as they could be. Although the concept of using no sedation on ventilated patients was completely foreign to me, it made sense based on what I had read in the literature. I devoured all of the episodes from the beginning, many of them bringing tears and regret for my ignorance, followed by inspiration and hope in later episodes. Listening to her podcast has been one of the most profound experiences in my short, eight-year career in medicine.

After discovering the no sedation, early mobility practice at the Awake and Walking ICU, my focus shifted to bringing it to my own institution. I visited Salt Lake City in March to witness it with my own eyes. Since then, I’ve been in touch closely with Kali and Louise to learn the practical approaches to sedation wean and sedation avoidance for newly intubated patients in the ICU.
Implementation has been challenged by pushback at the bedside, but knowing how most patients can be off sedation and comfortable allowed me to advocate for the patients. So far, four patients were successfully kept off of sedation after getting intubated, and two of them immediately smiled at me as they woke up from induction meds. Kali and the members of the Awake and Walking ICU have decades of experience in this approach.

Mikita Fuchita, MD

Kali Dayton’s consultancy energized our ICU to adopt the very latest evidence-based therapies to identify, prevent, and treat delirium with the ultimate goal being to eliminate preventable delirium by leveraging lessons shared by Kali to get our ICU patients awake, mobile, and walking.

The advice and tier-one support by Dayton ICU Consulting is a critical component of any ICU leader who wants to do better and make the greatest impact possible for patients so that they survive the ICU and go home to continue their livelihoods free of post-intensive care syndrome or PTSD.

Kali offers a powerful vector to ensure ICU care is state of the art.

Brian Delmonaco, MD, FACEP, Medical Director, Pulmonology and Critical Care Medicine, Samaritan Health Services

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Dayton ICU Consulting
Creating Awake and Walking ICUs
Email: info@daytonicuconsulting.com

The information associated with Dayton ICU Consulting across all media platforms is for informational/ educational purposes only. It is not meant to replace professional medical judgment and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors for Dayton ICU Consulting, LLC are not affiliated with, nor do they speak on behalf of any medical institutions, educational facilities, or other healthcare programs.