It's called the Clinical Scene Investigator (CSI) Academy. It's an effort of the American Association of Critical-Care Nurses (AACN) program designed to build nurses' expertise and leadership skills. The goal is to enhance patient care while decreasing costs. And it's already working.

The CSI Academy is now in six regional groups comprising 42 hospitals. So far, hospitals in Massachusetts, North Carolina, and Indiana have released results of their efforts, which show a combined anticipated savings of $20 million, according to program director Susan Lacey. The final groups, in New York, Pennsylvania, and Texas, are expected to announce their results later this year.

At participating institutions, a team of three or four staff nurses at a hospital work with a mentor and CSI faculty to identify problems related to patient care and investigate possible solutions. Each participating hospital received a $10,000 grant to support the team during its 16-month participation.

At Beth Israel Deaconess Medical Center in Boston, nurses participating in the program were able to decrease episodes of delirium by 60%, and the use of benzodiazepines was reduced by more than 80%. The projected annual savings at this one location was $1.7 million.

At St. Vincent Indianapolis Hospital, nurses created a "mobility team" to work with patients on ventilators, resulting in a 10-hour reduction in the average time patients were intubated. The projected annual savings was $337,000.

The AACN's Web site (http://www.aacn.org/csi) has a free database of information on each of the academy projects.-John Welsh, MN, RN