Strengthening ICU Outcomes through Enhanced APACHE IV Score Implementation and Monitoring

Abstract

Background: The APACHE IV scoring system is a validated tool for ICU mortality prediction and resource management. However, its underutilization due to staffing and technological constraints reduces its effectiveness in critical care settings.

Objectives: This project aimed to increase timely APACHE IV score completion, improve score accuracy, align actual outcomes with predicted values, and integrate scoring into routine ICU decision-making.

Methods: A prospective, unit-based process improvement project was implemented over four months (Dec 2024–Mar 2025) in the ICU. Interventions included staff training, EMR integration, compliance dashboards, and sepsis subgroup analysis.

Results: Completion rates of APACHE IV within 24 hours improved from 30% to >80%. ALOS remained below predicted ELS across risk categories. Sepsis EMR peaked at 58% in February but declined by 46% in March. ICU mortality and resource utilization trends improved despite persistent staffing challenges.

Conclusion: Timely APACHE IV implementation enhances ICU performance, enabling better outcome prediction and resource planning. Continued education, staffing support, and automation are vital for sustainability.