Can the impact of bed closure in intensive care units be reliably monitored? View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2004-02-28

AUTHORS

Jean-Blaise Wasserfallen, Jean-Pierre Revelly, Davide Moro, Nicolas Gilliard, Jacques Rouge, René Chioléro

ABSTRACT

Objective To assess the properties of various indicators aimed at monitoring the impact on the activity and patient outcome of a bed closure in a surgical intensive care unit (ICU).Design Comparison before and after the intervention.Setting A surgical ICU at a university hospital.Patients All patients admitted to the unit over two periods of 10 months.Intervention Closure of one bed out of 17.Measurements and results Activity and outcome indicators in the ICU and the structures upstream from it (emergency department, operative theater, recovery room) and downstream from it (intermediate care units). After the bed closure, the monthly medians of admitted patients and ICU hospital days increased from 107 (interquartile range 94–112) to 113 (106–121, P=0.07) and from 360 (325–443) to 395 (345–436, P=0.48), respectively, along with the linear trend observed in our institution. All indicators of workload, patient severity, and outcome remained stable except for SAPS II score, emergency admissions, and ICU readmissions, which increased not only transiently but also on a mid-term basis (10 months), indicating that the process of patient care delivery was no longer predictable.Conclusions Health care systems, including ICUs, are extraordinary flexible, and can adapt to multiple external constraints without altering commonly used activity and outcome indicators. It is therefore necessary to set up multiple indicators to be able to reliably monitor the impact of external interventions and intervene rapidly when the system is no longer under control. More... »

PAGES

1134-1139

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-004-2205-9

DOI

http://dx.doi.org/10.1007/s00134-004-2205-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1016835200

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/14991087


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