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Comparative Study
. 2014 Sep 6:14:76.
doi: 10.1186/1471-2253-14-76. eCollection 2014.

Introducing an integrated intermediate care unit improves ICU utilization: a prospective intervention study

Barbara C J Solberg  1 , Carmen D Dirksen  2 , Fred H M Nieman  2 , Godefridus van Merode  3 , Graham Ramsay  4 , Paul Roekaerts  5 , Martijn Poeze  6
Affiliations
Comparative Study

Introducing an integrated intermediate care unit improves ICU utilization: a prospective intervention study

Barbara C J Solberg et al. BMC Anesthesiol. .

Abstract

Background: Improvement of appropriate bed use and access to intensive care (ICU) beds is essential in optimizing utilization of ICU capacity. The introduction of an intermediate care unit (IMC) integrated in the ICU care may improve this utilization.

Method: In a before-after prospective intervention study in a university hospital mixed ICU, the impact of introducing a six-bed mixed IMC unit supervised and staffed by ICU physicians was investigated. Changes in ICU utilization (length of stay, frequency of mechanical ventilation use), nursing workload assessed byTISS-28 score, as well as inappropriate bed use, accessibility of the ICU (number of referrals), and clinical outcome indicators (readmission and mortality rates) were measured.

Results: During 17 months, data of 1027 ICU patients were collected. ICU utilization improved significantly with an increased appropriate use of ICU beds. However, the number of referrals, readmissions to the ICU and mortality rates did not decrease after the IMC was opened.

Conclusion: The IMC contributed to a more appropriate use of ICU facilities and did result in a significant increase in mean nursing workload at the ICU.

Keywords: Efficiency; Hospital bed capacity; Intensive care; Intermediate care; Resource allocation.

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Figures

Figure 1
Figure 1
Patient flow. N*, number of admissions; N**, number of readmissions; ICU, Intensive care unit; IMC, intermediate care unit; GW, general ward; LOS, length of stay.
See this image and copyright information in PMC

References

    1. Franklin C, Rackow EC, Mamdani B, Burke G, Weil MH. Triage considerations in medical intensive care. Arch Intern Med. 1990;150:1455–1459. doi: 10.1001/archinte.1990.00390190105016. - DOI - PubMed
    1. Bone RC, McElwee NE, Eubanks DH, Gluck EH. Analysis of indications for early discharge from the intensive care unit. Clinical efficacy assessment project: American College of Physicians. Chest. 1993;104(6):8112–8117. - PubMed
    1. Beck DH, McQuillan P, Smith GB. Waiting for the break of dawn? The effect of discharge time, discharge TISS-28 scores and discharge facility on hospital mortality after intensive care. Intensive Care Med. 2002;28:1287–1293. doi: 10.1007/s00134-002-1412-5. - DOI - PubMed
    1. Society of Critical Care Medicine Ethics Committee. Consensus statement on the triage of critically ill patients. JAMA. 1994;271:1200–1203. doi: 10.1001/jama.1994.03510390070032. - DOI - PubMed
    1. Dawson S, Runk JA. Right patient? Right bed? A question of appropriateness. AACN Clin Issues. 2000;11(3):375–385. doi: 10.1097/00044067-200008000-00005. - DOI - PubMed

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