High occupancy increases the risk of early death or readmission after transfer from intensive care*

Chrusch, Carla; Olafson, Kendiss; McMillan, Patricia M.; Roberts, Daniel; Gray, Perry R.

doi:10.1097/ccm.0b013e3181a57b0c

Cited by 104 publications

(91 citation statements)

References 26 publications

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“…However, as our study is observational and not interventional, a causal relationship between AKI status and postdischarge outcomes cannot be inferred from these data alone. Risk factors for adverse events in ICU survivors include high ICU bed occupancy, time of day at ICU discharge, severity of illness scores, organ failure indices, and discharge facility (49)(50)(51)(52). It is well described that ICU survivors suffer significant long-term morbidity and mortality (53).…”

Section: Discussionmentioning

confidence: 99%

The Association of Acute Kidney Injury in the Critically Ill and Postdischarge Outcomes

Horkan

Purtle

Mendu

et al. 2015

Critical Care Medicine

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Patients who suffer acute kidney injury are among a high-risk group of ICU survivors for adverse outcomes. In patients treated with critical care who survive hospitalization, acute kidney injury is a robust predictor of subsequent unplanned hospital readmission. In critical illness survivors, acute kidney injury is also associated with the odds of 30-day postdischarge mortality and the risk of subsequent end-stage renal disease.

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Section: Discussionmentioning

confidence: 99%

The Association of Acute Kidney Injury in the Critically Ill and Postdischarge Outcomes

Horkan

Purtle

Mendu

et al. 2015

Critical Care Medicine

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“…Whilst it reviewed contemporary research on ICU readmission, some of the studies used data that were collected prior to 2005. For example, a study published in 2009 used data collected before the year 2000 (Chrusch et al, 2009). As clinical support services such as ICU Liaison Nurses are relatively new, it is possible they did not exist in some hospitals during the data collection periods.…”

Section: Limitationsmentioning

confidence: 98%

Intensive care readmission: A contemporary review of the literature

Elliott

Worrall‐Carter

Page

2014

Intensive and Critical Care Nursing

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“…Most importantly, boarding critically ill patients in ED puts the patients at risk of higher adverse events and mortality [12,13], potentially increasing risk of ICU mortality by 1.5 % for each hour of waiting [14]. In addition to disrupting the workings of the ED, shortage of ICU beds could cause elective surgery cancellations [5,7], affect discharge decisions [15][16][17], and increase risk of early death [18].…”

Section: Introductionmentioning

confidence: 99%

Sustaining critical care: using evidence-based simulation to evaluate ICU management policies

Mahmoudian-Dehkordi

Sadat

2016

Health Care Manag Sci

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Intensive Care Units (ICU) are costly yet critical hospital departments that should be available to care for patients needing highly specialized critical care. Shortage of ICU beds in many regions of the world and the constant fire-fighting to make these beds available through various ICU management policies motivated this study. The paper discusses the application of a generic system dynamics model of emergency patient flow in a typical hospital, populated with empirical evidence found in the medical and hospital administration literature, to explore the dynamics of intended and unintended consequences of such ICU management policies under a natural disaster crisis scenario. ICU management policies that can be implemented by a single hospital on short notice, namely premature transfer from ICU, boarding in ward, and general ward admission control, along with their possible combinations, are modeled and their impact on managerial and health outcome measures are investigated. The main insight out of the study is that the general ward admission control policy outperforms the rest of ICU management policies under such crisis scenarios with regards to reducing total mortality, which is counter intuitive for hospital administrators as this policy is not very effective at alleviating the symptoms of the problem, namely high ED and ICU occupancy rates that are closely monitored by hospital management particularly in times of crisis. A multivariate sensitivity analysis on parameters with diverse range of values in the literature found the superiority of the general ward admission control to hold true in every scenario.

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High occupancy increases the risk of early death or readmission after transfer from intensive care*

Cited by 104 publications

References 26 publications

The Association of Acute Kidney Injury in the Critically Ill and Postdischarge Outcomes

The Association of Acute Kidney Injury in the Critically Ill and Postdischarge Outcomes

Intensive care readmission: A contemporary review of the literature

Sustaining critical care: using evidence-based simulation to evaluate ICU management policies

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