The process of intensive care triage

Levin, Phillip D.; Charles, Lesley

doi:10.1007/s001340101042

Cited by 49 publications

(35 citation statements)

References 8 publications

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“…Reduction or elimination of delays in transfer from the ICU have the potential to increase ICU-bed capacity effectively without the physical creation of new ICU beds. Previous publications have discussed the importance of ICU outflow in overall ICU resource utilization, yet few studies of this problem have been conducted [16]. The paucity of literature addressing the problem in our study suggests that the issue has not been adequately quantified and analyzed.…”

Section: Discussionmentioning

confidence: 87%

Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact

et al. 2013

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IntroductionA paucity of literature exists regarding delays in transfer out of the intensive care unit. We sought to analyze the incidence, causes, and costs of delayed transfer from a surgical intensive care unit (SICU).MethodsAn IRB-approved prospective observational study was conducted from January 24, 2010, to July 31, 2010, of all 731 patients transferred from a 20-bed SICU at a large tertiary-care academic medical center. Data were collected on patients who were medically ready for transfer to the floor who remained in the SICU for at least 1 extra day. Reasons for delay were examined, and extra costs associated were estimated.ResultsTransfer to the floor was delayed in 22% (n = 160) of the 731 patients transferred from the SICU. Delays ranged from 1 to 6 days (mean, 1.5 days; median, 2 days). The extra costs associated with delays were estimated to be $581,790 during the study period, or $21,547 per week. The most common reasons for delay in transfer were lack of available surgical-floor bed (71% (114 of 160)), lack of room appropriate for infectious contact precautions (18% (28 of 160)), change of primary service (Surgery to Medicine) (7% (11 of 160)), and lack of available patient attendant ("sitter" for mildly delirious patients) (3% (five of 160)). A positive association was found between the daily hospital census and the daily number of SICU beds occupied by patients delayed in transfer (Spearman rho = 0.27; P < 0.0001).ConclusionsDelay in transfer from the SICU is common and costly. The most common reason for delay is insufficient availability of surgical-floor beds. Delay in transfer is associated with high hospital census. Further study of this problem is necessary.

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Section: Discussionmentioning

confidence: 87%

Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact

et al. 2013

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“…Older age, pre-hospital dependency, and underlying diseases were associated with refusal for toosick-to-benefit status. A limitation of this study is that there was probably a population of patients who might have benefited from treatment in the ICU but for whom ICU admission was not requested [13]. We had no means of estimating the size of this population.…”

Section: Discussionmentioning

confidence: 99%

Triaging patients to the ICU: a pilot study of factors influencing admission decisions and patient outcomes

Garrouste-Orgeas¹,

Montuclard²,

Timsit³

et al. 2003

Intensive Care Med

121

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“…The final result of the triage process is influenced by factors leading to the request for ICU admission (pretriage phase), by intensivists' evaluations of the appropriateness of ICU admission (triage strictly speaking), and by the availability of ICU beds (posttriage phase) (8). Recommendations for ICU admission and discharge (9) have been issued but are not followed by French ICU physicians, in particular when triage is done over the phone and when the unit is full (10).…”

mentioning

confidence: 99%

Predictors of intensive care unit refusal in French intensive care units: A multiple-center study*

Garrouste-Orgeas

Montuclard

Timsit

et al. 2005

Critical Care Medicine

201

119

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The process of intensive care triage

Cited by 49 publications

References 8 publications

Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact

Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact

Triaging patients to the ICU: a pilot study of factors influencing admission decisions and patient outcomes

Predictors of intensive care unit refusal in French intensive care units: A multiple-center study*

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