A quality improvement study on how a simulation model can help decision making on organization of ICU wards.
BMC Health Serv Res
; 24(1): 708, 2024 Jun 05.
Article
en En
| MEDLINE
| ID: mdl-38840245
ABSTRACT
BACKGROUND:
Intensive Care Unit (ICU) capacity management is essential to provide high-quality healthcare for critically ill patients. Yet, consensus on the most favorable ICU design is lacking, especially whether ICUs should deliver dedicated or non-dedicated care. The decision for dedicated or non-dedicated ICU design considers a trade-off in the degree of specialization for individual patient care and efficient use of resources for society. We aim to share insights of a model simulating capacity effects for different ICU designs. Upon request, this simulation model is available for other ICUs.METHODS:
A discrete event simulation model was developed and used, to study the hypothetical performance of a large University Hospital ICU on occupancy, rejection, and rescheduling rates for a dedicated and non-dedicated ICU design in four different scenarios. These scenarios either simulate the base-case situation of the local ICU, varying bed capacity levels, potential effects of reduced length of stay for a dedicated design and unexpected increased inflow of unplanned patients.RESULTS:
The simulation model provided insights to foresee effects of capacity choices that should be made. The non-dedicated ICU design outperformed the dedicated ICU design in terms of efficient use of scarce resources.CONCLUSIONS:
The choice to use dedicated ICUs does not only affect the clinical outcome, but also rejection- rescheduling and occupancy rates. Our analysis of a large university hospital demonstrates how such a model can support decision making on ICU design, in conjunction with other operation characteristics such as staffing and quality management.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Mejoramiento de la Calidad
/
Unidades de Cuidados Intensivos
Límite:
Humans
Idioma:
En
Revista:
BMC Health Serv Res
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
Año:
2024
Tipo del documento:
Article
País de afiliación:
Países Bajos