Cost‐effective use of the surgical intensive care unit

Abstract

The intensive care unit (ICU) continues to be a large user of resources. There is a continued need for a balance of cost‐effective utilization and quality patient care. A data base of information currently exists that defines those groups of patients in whom reasonable success in resource allocation can be anticipated. In other cases, attempts are being made to define variables that adequately predict survival so they can be used to effect care decisions. Although some progress has been made, considerable work is needed to achieve both of these. For surgeons, the ICU has become an essential “part of the knife.” It is a necessity in modern high‐technology care and has become an essential element in surgical training programs. The use of the ICU for currently conceived high‐risk patients is now commonplace. A growing database supports this preoperative use of ICU resources. Techniques are now available to make ICU care more cost‐effective. Tools such as not having routine orders, daily rewriting of all orders, review of drug orders, and the utilization of the laboratory and radiographic resources have already reduced significantly the real cost of using these life‐saving facilities.