OBJECTIVE To examine clinical outcomes before and after implementation of a telemedicine program in the intensive care units of a five-hospital healthcare system. DESIGN Observational study with the baseline period of 1 yr before the start of a telemedicine intensive care unit program implementation at each of 5 hospitals. The post periods are 1, 2, and 3 yrs after telemedicine intensive care...

OBJECTIVES To evaluate a new organizational model in an intensive care unit, with the implementation of early warning systems and a support unit. DESIGN A retrospective, comparative cohort study was carried out. SETTING The study was carried out in the Department of Intensive Care Medicine (DICM) of a tertiary hospital (2009-2011), with the comparison of three time periods (P1, P2 and P3) t...

CONTEXT An ongoing process of identifying and implementing breakthrough projects to quickly improve patient outcomes and reduce costs in the intensive care unit. OBJECTIVE To develop and test a new protocol for heparin administration in the intensive care unit, replacing the 5 existing protocols and ensuring compliance with the recommendations of the Fifth American College of Chest Physicians...

OBJECTIVE To determine whether availability of neonatal intensive care cots is a problem in any or all parts of the United Kingdom. DESIGN Three month census from 1 April to 30 June 1999 comprising simple data sheets on transfers out of tertiary units. SETTING The 37 largest high risk perinatal centres in the United Kingdom. PARTICIPANTS One obstetric specialist and one neonatal specialis...

The work of the respiratory intensive care unit at the Glasgow Royal Infirmary covering a period of 10 years and involving more than 2,000 patients has been analysed. The rate of admission of patients with acute respiratory or metabolic disturbances remained surprisingly constant over the years, allowing for the increase in available beds after 1965. A disturbing feature was the notable increas...

Intensive care units (ICUs) have become an increasingly important part of the American health care delivery system. In 2000, critical care cost $55.5 billion—13.3 percent of total hospital costs and half a percent of the United States’ gross domestic product. As the population continues to age and the severity of hospital cases continues to increase, the role of the intensive care in hospital e...

OBJECTIVE To determine what influences doctors' decisions about admission of patients to intensive care. DESIGN National questionnaire survey using eight clinical vignettes involving hypothetical patients. SETTING Switzerland. PARTICIPANTS 402 Swiss doctors specialising in intensive care. MAIN OUTCOME MEASURES Rating of factors influencing decisions on admission and response to eight hy...

BACKGROUND Allocation of scarce resources presents an increasing challenge to hospital administrators and health policy makers. Intensive care units can present bottlenecks within busy hospitals, but their expansion is costly and difficult to gauge. Although mathematical tools have been suggested for determining the proper number of intensive care beds necessary to serve a given demand, the per...

Most hospitals are facing the dilemma caused by demand for critical care beds outstripping supply. This imbalance is likely to get worse over the coming years as a result of many factors, including aging of the population, improved technology, and improved therapies, among other factors. As a result we are likely to have to make further tough decisions about rationing of this service. In this i...