Potential Impact of Reduced Critical Care Pharmacist-to-Patient Ratios: An OPTIM Subgroup Analysis

Sunday, March 22, 2026

12:15 PM - 1:15 PM Central Time

Location: Connections Central - RST 03

Aly T. Basting, PharmD

Indiana University Health – Adult Academic Health Center, Indiana

Disclosure(s): No relevant financial relationship(s) to disclose.
CA

Christopher Anderson, PharmD, BCPS

Clinical Pharmacy Specialist, Critical Care
Indiana University Health – Adult Academic Health Center

Disclosure information not submitted.
EA

Eve Anderson, PharmD, BCPS, BCCCP

Clinical Pharmacy Specialist, Critical Care
Indiana University Health – Adult Academic Health Center

Disclosure information not submitted.
EM

Emily Miller, PharmD, BCCCP, FCCM

Manager, Inpatient Clinical Pharmacy Services
Indiana University Health – Adult Academic Health Center

Disclosure information not submitted.
JS

Joey Stoldt, PharmD, BCPS, BCCCP

Clinical Pharmacy Specialist, Critical Care
Indiana University Health – Adult Academic Health Center

Disclosure information not submitted.
SV

Storm Van Wey, PharmD, MS

Clinical Pharmacy Specialist, Critical Care
Indiana University Health – Adult Academic Health Center

Disclosure information not submitted.
DV

Dalena Vo, PharmD, BCCCP

Pharmacist - Investigational Drug Service
Indiana University Simon Cancer Center

Disclosure information not submitted.
RK

Rachel Kruer, PharmD, BCCCP, FCCM, CNSC

Manager, Inpatient Clinical Pharmacy Services
Indiana University Health – Adult Academic Health Center

Disclosure information not submitted.

Introduction: Consensus on the ideal critical care pharmacist (CCP)-to-patient ratio is lacking. At a large US academic medical center eight CCPs cover eight critical care service lines with a median CCP-to-patient ratio of 1:23. The center is constructing a new campus featuring multiple 32-bed intensive care units (ICUs), each divided into two 16-bed neighborhoods. This upcoming enhancement presents the potential to lower the CPP-to-patient ratio to 1:16. This study aimed to assess the relationship between CCP-to-patient ratios and patient outcomes, offering insight into optimal staffing strategies for CCPs.

Methods: This retrospective, observational study is a sub-analysis of a single large academic medical center’s data obtained from the OPTIM study. Patients admitted to five ICUs between 8/14/2023 to 12/31/2023 were included. Patients were divided into groups based on their median CCP-to-patient ratio. The primary outcome was mortality. The secondary outcomes were ICU readmission, ICU and hospital length of stay (LOS).

Results: A total of 1238 patients comprising 6698 patient days were included with 350 (28.3%) patients in the CCP-to-patient ratio of ≤ 1:16 group and 888 (71.7%) in the CCP-to-patient ratio of > 1:16 group. Most patients were admitted to the trauma ICU (32.2%) followed by the neuro ICU (27%) with a total median ICU LOS of 3.3 [1.8 – 6.6] days. The median SOFA and MRC scores within 24 hours of admission were 3 [1 – 6] and 8.5 [5 – 13], respectively. The overall median CCP-to-patient ratio was 1:24 [1:16 – 1:60]. A CCP-to-patient ratio of ≤ 1:16 was associated with a reduction in mortality compared to a ratio of > 1:16 (23 (6.6%) vs 96 (10.8%) p = 0.023). ICU and hospital LOS were shorter in the ≤ 1:16 group (2.3 [1.4 – 4.7] vs 3.8 [2.0 – 7.6] days, p < 0.001 and 8.1 [4.5 – 13.3] vs 9.6 [5.4 – 17.8] days, p = 0.004 respectively). No difference was seen in ICU readmission rates.

Conclusions: A CCP-to-patient ratio of ≤ 1:16 was associated with a reduction in mortality and shorter ICU and hospital LOS, highlighting the potential benefits of optimal CCP staffing. Further investigation is warranted to find the ideal CCP-to-patient ratio and assess its broader impact on patient outcomes.