A national system for monitoring intensive care unit demand and capacity: the Critical Health Resources Information System (CHRIS)

Pilcher, David; Coatsworth, Nicholas; Rosenow, Melissa; McClure, Jason

doi:10.5694/mja2.50988

Cited by 16 publications

(20 citation statements)

References 9 publications

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“…However, given the second wave was more geographically isolated, with a much smaller number of hospitals managing these cases, it is likely resources, staff and equipment were affected locally. 16 Data from this study illustrate that clinical management changed over the course of the COVID-19 pandemic. Several early guidelines suggested avoiding non-invasive ventilation and high flow oxygen due to concerns about aerosolisation of SARS-CoV-2, and instead recommended earlier intubation.…”

Section: Relationship To Previous Studiesmentioning

confidence: 82%

“…Craig J French 1,9 John M Kaldor 10 Edward Litton 11,12 Srinivas Murthy 13 Richard E McAllister 14 Alistair D Nichol 1,2 Annamaria Palermo 11 Mark P Plummer 15 Mahesh Ramanan 16 Benjamin AJ Reddi 17,18 Claire Reynolds 19 Steve A Webb 1,12 Andrew A Udy 1,2 For the SPRINT SARI Australia Investigators* * The list of SPRINT-SARI Australia Investigators is also available in the Online Appendix.…”

Section: Competing Interestsmentioning

confidence: 99%

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Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Burrell¹,

Neto²,

Broadley³

et al. 2021

Critical Care and Resuscitation

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OBJECTIVE: To report longitudinal differences in baseline characteristics, treatment, and outcomes in patients with coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) between the first and second waves of COVID-19 in Australia. DESIGN, SETTING AND PARTICIPANTS: SPRINT-SARI Australia is a multicentre, inception cohort study enrolling adult patients with COVID-19 admitted to participating ICUs. The first wave of COVID-19 was from 27 February to 30 June 2020, and the second wave was from 1 July to 22 October 2020. RESULTS: A total of 461 patients were recruited in 53 ICUs across Australia; a higher number were admitted to the ICU during the second wave compared with the first: 255 (55.3%) versus 206 (44.7%). Patients admitted to the ICU in the second wave were younger (58.0 v 64.0 years; P = 0.001) and less commonly male (68.9% v 60.0%; P = 0.045), although Acute Physiology and Chronic Health Evaluation (APACHE) II scores were similar (14 v 14; P = 0.998). High flow oxygen use (75.2% v 43.4%; P < 0.001) and non-invasive ventilation (16.5% v 7.1%; P = 0.002) were more common in the second wave, as was steroid use (95.0% v 30.3%; P < 0.001). ICU length of stay was shorter (6.0 v 8.4 days; P = 0.003). In-hospital mortality was similar (12.2% v 14.6%; P = 0.452), but observed mortality decreased over time and patients were more likely to be discharged alive earlier in their ICU admission (hazard ratio, 1.43; 95% CI, 1.13–1.79; P = 0.002). CONCLUSION: During the second wave of COVID-19 in Australia, ICU length of stay and observed mortality decreased over time. Multiple factors were associated with this, including changes in clinical management, the adoption of new evidence-based treatments, and changes in patient demographic characteristics but not illness severity.

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Section: Relationship To Previous Studiesmentioning

confidence: 82%

Section: Competing Interestsmentioning

confidence: 99%

Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Burrell¹,

Neto²,

Broadley³

et al. 2021

Critical Care and Resuscitation

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“…Differences in the additional registered nursing FTEs that could be provided suggest that the ability to respond to a surge in demand varies between and within states. The Critical Health Resources Information System (CHRIS), which collects data on ICU activity, resources, and demand throughout Australia, was used in 2020 to identify ICUs under strain in Melbourne and to facilitate safe transfer of patients from the ICUs with greatest demand to ICUs with the greatest capacity 11‐13 …”

Section: Discussionmentioning

confidence: 99%

Increasing ICU capacity to accommodate higher demand during the COVID‐19 pandemic

Litton

Huckson²,

Chavan³

et al. 2021

Medical Journal of Australia

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Objectives To describe the short term ability of Australian intensive care units (ICUs) to increase capacity in response to heightened demand caused by the COVID‐19 pandemic. Design Survey of ICU directors or delegated senior clinicians (disseminated 30 August 2021), supplemented by Australian and New Zealand Intensive Care Society (ANZICS) registry data. Setting All 194 public and private Australian ICUs. Main outcome measures Numbers of currently available and potentially available ICU beds in case of a surge; available levels of ICU‐relevant equipment and staff. Results All 194 ICUs responded to the survey. The total number of currently open staffed ICU beds was 2183. This was 195 fewer (8.2%) than in 2020; the decline was greater for rural/regional (18%) and private ICUs (18%). The reported maximal ICU bed capacity (5623) included 813 additional physical ICU bed spaces and 2627 in surge areas outside ICUs. The number of available ventilators (7196) exceeded the maximum number of ICU beds. The reported number of available additional nursing staff would facilitate the immediate opening of 383 additional physical ICU beds (47%), but not the additional bed spaces outside ICUs. Conclusions The number of currently available staffed ICU beds is lower than in 2020. Equipment shortfalls have been remediated, with sufficient ventilators to equip every ICU bed. ICU capacity can be increased in response to demand, but is constrained by the availability of appropriately trained staff. Fewer than half the potentially additional physical ICU beds could be opened with currently available staff numbers while maintaining pre‐pandemic models of care.

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“…The systems for ICU capacities monitoring employed in various countries are usually operated under the auspices of national authorities (ie, government, ministries, and armed forces). They have been designed to provide near real-time data for crisis management and decision-making [19][20][21]. Short-and long-term estimates of ICU bed occupancy in the upcoming days and weeks using statistical models are another important output [21,22].…”

Section: Discussionmentioning

confidence: 99%

Control Centre for Intensive Care as a Tool for Effective Coordination, Real-Time Monitoring, and Strategic Planning During the COVID-19 Pandemic

Komenda¹,

Černý²,

Šnajdárek³

et al. 2022

J Med Internet Res

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In the Czech Republic, the strategic data-based and organizational support for individual regions and for providers of acute care at the nationwide level is coordinated by the Ministry of Health. At the beginning of the COVID-19 pandemic, the country needed to very quickly implement a system for the monitoring, reporting, and overall management of hospital capacities. The aim of this viewpoint is to describe the purpose and basic functions of a web-based application named “Control Centre for Intensive Care,” which was developed and made available to meet the needs of systematic online technical support for the management of intensive inpatient care across the Czech Republic during the first wave of the pandemic in spring 2020. Two tools of key importance are described in the context of national methodology: one module for regular online updates and overall monitoring of currently free capacities of intensive care in real time, and a second module for online entering and overall record-keeping of requirements on medications for COVID-19 patients. A total of 134 intensive care providers and 927 users from hospitals across all 14 regions of the Czech Republic were registered in the central Control Centre for Intensive Care database as of March 31, 2021. This web-based application enabled continuous monitoring and decision-making during the mass surge of critical care from autumn 2020 to spring 2021. The Control Center for Intensive Care has become an indispensable part of a set of online tools that are employed on a regular basis for crisis management at the time of the COVID-19 pandemic.

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A national system for monitoring intensive care unit demand and capacity: the Critical Health Resources Information System (CHRIS)

Cited by 16 publications

References 9 publications

Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Increasing ICU capacity to accommodate higher demand during the COVID‐19 pandemic

Control Centre for Intensive Care as a Tool for Effective Coordination, Real-Time Monitoring, and Strategic Planning During the COVID-19 Pandemic

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