OBJECTIVES The purpose of this study was to describe the process used to decide which patients are admitted to the intensive care unit (ICU) at a hospital with special focus on access for neurosurgery patients, and evaluate it using "accountability for reasonableness". METHODS Qualitative case study methodology was used. Data were collected from documents, interviews with key informants, and ...

Critical care is both expensive and increasing. Emergency department (ED) management of critically ill patients before intensive care unit (ICU) admission is an under-explored area of potential cost saving in the ICU. Although limited, current data suggest that ED care has a significant impact on ICU costs both positive and negative. ICU practices can also affect the ED, with a lack of ICU beds...

OBJECTIVE To develop a predictive equation that estimates the probability of life-supporting therapy among ICU monitor admissions and to explore its potential for reducing cost and improving ICU utilization. DESIGN Prospective inception cohort analysis. PARTICIPANTS Forty-two ICUs in 40 US hospitals with more than 200 beds and a consecutive sample of 17,440 ICU admissions. INTERVENTIONS A...

As I am driving to work, the local radio headlines tell me that our hospital has over 30 empty beds in intensive care unit. Strange, that—as it was a struggle for us any new critically ill patients yesterday. Staff sickness, combined with covid-19, and on top of usual demands day-to-day life, meant tough shift. Still, something major must have happened 12 hours since left, as we now apparently ...

Introduction Since 2000, there has been a marked reduction in nonclinical critical care transfers in England. ICNARC have reported that this has been associated with a reduction in case-mix adjusted mortality (1). One consequence has been the need to open critical care beds in non-specified locations in hospitals such as post anaesthesia recovery and high dependency areas. Here we report the co...

SETTING The hill district in Nepal, where access to health care facilities is difficult. OBJECTIVE To compare results before and after a decentralised directly observed treatment (DOT) intervention. DESIGN Prospective study of patients registered in Dhankuta district, Nepal, 1996-1999. Patients received their intensive phase treatment under health worker supervision via one of three DOT opt...

INTRODUCTION Globally about 8% to 10% of newborns require neonatal intensive care (NICU) care. Families face emotional and financial difficulties when their sick newborns are hospitalized for prolonged periods in a NICU. METHODS We conducted a study to assess the feasibility and acceptance of an Internet-based telemedicine program in an intensive care setting and to evaluate its impact on new...

OBJECTIVE To investigate workflow in intensive care unit remote monitoring, a technology-driven practice that allows critical care specialists to perform proactive and continuous patient care from a remote site. DESIGN A time-and-motion study. SETTING Facility that remotely monitored 132 beds in nine intensive care units. PARTICIPANTS Six physicians and seven registered nurses. INTERVEN...

BACKGROUND Intensive care unit (ICU) beds, a scarce resource, may require prioritization of admissions when demand exceeds supply. We evaluated the effect of ICU bed availability on processes and outcomes of care for hospitalized patients with sudden clinical deterioration. METHODS We identified consecutive hospitalized adults in Calgary, Alberta, Canada, with sudden clinical deterioration tr...

Introduction / objectives The rate of bloodstream infections has been monitored monthly since 2004 at Aarhus University Hospital, Skejby. The hospital is a tertiary referral hospital with 400 beds specialising in paediatrics, gynaecology & obstetrics, urology, thoracic and vascular surgery, renal medicine, cardiology, infectious diseases and intensive care. The aim of this study was to identify...