Critically Examining Intensive Care

Miranda, Dinis Reis

doi:10.1017/s0266462300013738

Cited by 4 publications

(1 citation statement)

References 39 publications

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“…Intensive care is considered to be an expensive specialty. In the US, intensive care units (ICUs) consume approximately 20% of total hospital costs but comprise less than 10% of all hospital beds [11][12][13]. The UK spends an estimated £675 million per year on intensive care [14] which represents about 2% of the hospital budget.…”

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confidence: 99%

The development of a method for comparative costing of individual intensive care units

et al. 1999

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SummaryIntensive care is one of the most costly areas of hospital care. Unfortunately, because of the diversity of case mix, costing intensive care is difficult. Many described costing methods previously are limited by being cumbersome, laborious to apply and expensive. The aim of this study was to develop a method for costing intensive care which can be applied with ease but facilitate meaningful cost comparisons between intensive care units. The method developed was based on cost blocks where the major components were identified and costed in a 'top-down' manner. Using strict definitions, the cost blocks attempted to measure the costs of equipment, estates, nonclinical support services (such as hospital management costs), clinical support services (such as physiotherapy, laboratory services), consumables (such as drugs, fluids and disposables) and staff. The study found that clinical support services, consumables and staff costs accounted for approximately 85% of the total costs.

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The development of a method for comparative costing of individual intensive care units

et al. 1999

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Will he get back to normal? Survival and functional status after intensive care therapy

Gardner

Sibthorpe²

2002

Intensive and Critical Care Nursing

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Sociotechnical Issues of Tele-ICU Technology

Hoonakker

McGuire

Carayon

2011

Information and Communication Technologies, Society and Human Beings

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Intensive care units (ICUs) are highly complex organizations where lives are hanging by a thread. Approximately 400,000 to 500,000 people die each year in American ICUs. The highly complex environment and large responsibilities put a burden on ICU staff including physicians and nurses. Research has shown that ICU physicians and nurses report high levels of workload and burnout that are related to lower quality of care provided to ICU patients and patient safety problems. Furthermore, there is a shortage of ICU personnel. In the past decades, the number of critical care beds has increased while the number of hospitals offering critical care services has decreased. Telemedicine may be one solution to deal with the shortage of ICU personnel. The tele-ICU technology represents the application of telemedicine in ICUs: ICU patients are monitored remotely by physicians and nurses trained in critical care. Recent estimates show that a nurse in the tele-ICU environment can monitor as many as 50 ICU patients in different ICUs, using the most recent telemedicine technology that provides access to patient information as well as video and audio links to patient rooms. The physicians and nurses in the tele-ICU collaborate with the physicians and nurses in the ICUs in what can be considered virtual teams. We know little about how the virtual team characteristics affect communication and trust between the participating members of the team. Furthermore, we know little about how the technological environment of the tele-ICU may affect the physicians and nurses’ workload and possibly burnout, and how this may affect quality of care and patient safety. In this chapter we describe the ICU and tele-ICU from a sociotechnical perspective, and examine how organizational factors may affect the jobs of nurses in the tele-ICU, and possible consequences for quality of work life, quality of care and patient safety.

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Critically Examining Intensive Care

Cited by 4 publications

References 39 publications

The development of a method for comparative costing of individual intensive care units

The development of a method for comparative costing of individual intensive care units

Will he get back to normal? Survival and functional status after intensive care therapy

Sociotechnical Issues of Tele-ICU Technology

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