Operational Excellence

Document Type


Publication Date

Fall 9-5-2019


Operational Excellence, Maine Medical Center

MeSH Headings

academic, medical center, patients, alcohol use disorder, critical care unit, quality improvement, ICU, root cause analysis, documentation, alcohol withdrawal, length of stay


The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as hospital length of stay were realized. Next steps include further data analysis and prepare for publication.