Stanford Team Reduces VAP in TBI patients by 50%
June 27, 2025
A Stanford Surgery team has reduced the odds of ventilator-associated pneumonia (VAP) in severe traumatic brain injury (TBI) patients by 50% in the SICU.
The team, led by Surgical Critical Care Fellow Dr. Harrison Chau and supported by nurse coordinators/educators Emily Zwissig, Shelby Murphy, and Felix Navarro from Stanford’s SICU K4 unit was part of the Spring Realizing Improvement through Team Empowerment (RITE) program. According to their research, there was a steady increase in VAP cases since Spring 2023.
The team implemented targeted interventions including a process map for severe TBI patients and a TBI VAP prevention checklist reducing VAP usage from 14% to 7%. This reduction in VAP translates to 1-2 fewer patients of VAP per six months and ~$50,000 in health care cost savings.
“This amazing team brought tremendous resilience, energy, and commitment to the work. We’re proud of their accomplishments and excited to see the positive impact on patient outcomes,” said Amin Etemad Rezai, who served as the team’s coach. “Special kudos and gratitude to our sponsors, Dr. Joe Forrester, and Dr. Lisa Knowlton, for their steadfast support and dedication to continuous improvement.”
The team’s next steps include exploring prophylactic antibiotics, the EPIC admission order set, and EOLAS protocol. By Spring 2026 they hope to reduce the odds ratio of VAP in severe TBI patients to below 1.
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