Seasonal bed closures in an intensive care unit: A qualitative study

Rocker, Graeme; Cook, Deborah J.; Martin, Douglas K.; Сингер, Петер

doi:10.1053/jcrc.2003.yjcrc6

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…All four conditions, publicity, relevance, appeals and enforcement needed to be satisfied. This has been previously described in other settings [12,[19][20][21][22].…”

Section: The Processmentioning

confidence: 70%

Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study

2007

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“…All four conditions, publicity, relevance, appeals and enforcement needed to be satisfied. This has been previously described in other settings [12,[19][20][21][22].…”

Section: The Processmentioning

confidence: 70%

Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study

2007

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“…Moreover, as the health of our aging population deteriorates, and as critical care becomes more expensive, the need to optimize triage and rationing decisions will intensify. Our scarce critical care resources underscore the need to examine triaging and rationing using policy analysis and qualitative research (36). Although the studies in this systematic review represent the totality of the literature in this area, the observational nature, heterogeneity, moderate to poor methodological quality, and lack of succinct conclusions of the individual studies preclude strong conclusions.…”

Section: Resultsmentioning

confidence: 99%

Rationing critical care beds: A systematic review*

Sinuff

Kahnamoui

Cook

et al. 2004

Critical Care Medicine

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These studies suggest that patients who are perceived not to benefit from critical care are more often refused intensive care unit admission; refusal is associated with an increased risk of hospital death. During times of decreased critical bed availability, several factors, including age, illness severity, and medical diagnosis, are used to triage patients, although their relative importance is uncertain. Critical care bed rationing requires further investigation.

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“…It was beyond the scope of this survey to evaluate personnel (dieticians, nurses, pharmacists, physicians, physiotherapists, respiratory therapists, social workers) or other resources that are essential to the care of critically ill patients. Indeed, lack of available critical care clinical staff is among the most common reason for limitations in bed availability [25][26][27]. Future resource planning must address this key knowledge gap.…”

Section: Discussionmentioning

confidence: 99%

Critical care capacity in Canada: results of a national cross-sectional study

et al. 2015

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IntroductionIntensive Care Units (ICUs) provide life-supporting treatment; however, resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity.MethodsAfter the 2009–2010 Influenza A (H1N1) pandemic, the Canadian Critical Care Trials Group surveyed all acute care hospitals in Canada to assess ICU capacity. Using a structured survey tool administered to physicians, respiratory therapists and nurses, we determined the number of ICU beds, ventilators, and the ability to provide specialized support for respiratory failure.ResultsWe identified 286 hospitals with 3170 ICU beds and 4982 mechanical ventilators for critically ill patients. Twenty-two hospitals had an ICU that routinely cared for children; 15 had dedicated pediatric ICUs. Per 100,000 population, there was substantial variability in provincial capacity, with a mean of 0.9 hospitals with ICUs (provincial range 0.4-2.8), 10 ICU beds capable of providing mechanical ventilation (provincial range 6–19), and 15 invasive mechanical ventilators (provincial range 10–24). There was only moderate correlation between ventilation capacity and population size (coefficient of determination (R2) = 0.771).ConclusionICU resources vary widely across Canadian provinces, and during times of increased demand, may result in geographic differences in the ability to care for critically ill patients. These results highlight the need to evolve inter-jurisdictional resource sharing during periods of substantial increase in demand, and provide background data for the development of appropriate critical care capacity benchmarks.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0852-6) contains supplementary material, which is available to authorized users.

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Seasonal bed closures in an intensive care unit: A qualitative study

Cited by 13 publications

References 18 publications

Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study

Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study

Rationing critical care beds: A systematic review*

Critical care capacity in Canada: results of a national cross-sectional study

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