Descriptive analysis of critical care units in the United States

Groeger, Jeffrey S.; Guntupalli, Kalpalatha K.; Strosberg, Martin A.; Halpern, Neil A.; Raphaely, Russell C.; Cerra, Frank B.; Kaye, William

doi:10.1097/00003246-199302000-00022

Cited by 267 publications

(46 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in line with national averages as reported byShortell et al (1994) who, in a study of 42 hospitals with ICUs, found that the average ratio was 1.5, and byGroeger et al (1992) who, in a much larger study, claim that the ratio for critical care was approximately 2:1.4 Can happen if it was not possible to determine the severity of a patient's injury when he/she was first admitted.N.L. Hyer et al / Journal of Operations Management 27 (2009) 203-219…”

supporting

confidence: 86%

“…It appeared to have done so successfully, turning a service line operating at a loss and at the risk of closing into a profitable enterprise for the hospital. Since intensive care units (ICUs) consume about 15-20% of hospitals' budgets, amounting to about 1% of United States' GDP (Groeger et al, 1992), and future hospitals may largely consist of ICUs (Shortell et al, 1994), critical care -such as trauma care -is an area of great importance both in human and economic terms.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Performance analysis of a focused hospital unit: The case of an integrated trauma center

Hyer

Wemmerlöv

Morris

2008

J of Ops Management

111

View full text Add to dashboard Cite

The concept of focus [Skinner, W., 1974. The focused factory. Harvard Business Review 52 (3), 113–121], notably operationalized in manufacturing entities like cells and focused factories, has also been adopted by the health care industry. Examples include patient‐focused care systems and product/service lines. Despite its longevity, there is a paucity of studies analyzing the focus concept and its link to performance, especially in health care. This research is aimed at enhancing our understanding of how a focus‐based approach to organization redesign in health care affects processes and practices, and what operational, clinical, and financial outcomes result from such a change. The research setting is a single case site within a large medical center for which costs for trauma care used to exceed income. Using a structured framework, we document the design and operation of this physically and organizationally integrated Level I trauma care center and compare it to its preceding operation. Its pre‐ and post‐conversion performance is analyzed using symmetric event windows covering three‐year periods before and after the focused hospital unit (FHU) was established. Under a sizable increase in workload, we find no change in mortality, moderate improvement in length of stay, and a large improvement in net operating margins. Surprisingly, the latter stem not from reductions in cost but in sharply increased hospital reimbursements. Previous studies of hospital restructuring involving focused patient populations have not conclusively supported a positive link between focus and outcomes. However, this investigation of a specific FHU suggests, conceptually as well as quantitatively, that focus can be an attractive element in health care system design.

show abstract

supporting

confidence: 86%

mentioning

confidence: 99%

Performance analysis of a focused hospital unit: The case of an integrated trauma center

Hyer

Wemmerlöv

Morris

2008

J of Ops Management

111

View full text Add to dashboard Cite

show abstract

“…Delivery of critical care services around the world is not standardized (13,14,51). The EPIC study of 1,417 European ICUs revealed that almost one third of European ICUs lack an ICU director, and nearly one fourth do not have 24-hr physician coverage (14).…”

Section: Discussionmentioning

confidence: 99%

“…The EPIC study of 1,417 European ICUs revealed that almost one third of European ICUs lack an ICU director, and nearly one fourth do not have 24-hr physician coverage (14). In a survey from the United States, a full-time unit director was present in 20% of hospitals with Ͻ100 beds and in 60% of hospitals with Ͼ500 beds (13). In the same survey, a closed policy was enforced in only 22% of ICUs (13).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of closed unit policy and appointing an intensivist in a developing country*

Topeli

Laghi

Tobin

2005

Critical Care Medicine

View full text Add to dashboard Cite

show abstract

Epoetin Alfa

Henry¹,

Bowers²,

Romano³

et al. 2004

Arch Intern Med

View full text Add to dashboard Cite

Recombinant human erythropoietin (epoetin alfa) has been used in clinical settings for more than a decade. Its indications have expanded considerably from its original use as hormone therapy in the treatment of anemia in adults with chronic kidney disease. Since the introduction of epoetin alfa, a greater understanding of anemia pathophysiology and the interactions of erythropoietin, iron, and erythropoiesis has been elucidated. Anemia is now independently associated with increased mortality and disease progression. Potential survival benefits associated with correction of anemia in various patient populations are leading to consideration of earlier, more aggressive treatment of mild to moderate anemia with epoetin alfa. Moreover, this agent's therapeutic use may extend beyond currently accepted roles. Epoetin alfa is undergoing evaluation with promising results in a variety of new clinical settings, including anemia associated with congestive heart failure, ribavirin-interferon alfa treatment of hepatitis C virus infection, and critical illness. Preclinical studies also have established erythropoietin and its recombinant equivalent to be a pleiotropic cytokine with antiapoptotic activity and neuroprotective actions in the central nervous system. The therapeutic potential of epoetin alfa appears yet to be fully realized.

show abstract

Descriptive analysis of critical care units in the United States

Cited by 267 publications

References 0 publications

Performance analysis of a focused hospital unit: The case of an integrated trauma center

Performance analysis of a focused hospital unit: The case of an integrated trauma center

Effect of closed unit policy and appointing an intensivist in a developing country*

Epoetin Alfa

Contact Info

Product

Resources

About