Central Surgical AssociationUsing simulation to determine the need for ICU beds for surgery patients
Section snippets
Methods
To perform the study, the first author spent approximately 125 hours performing the steps explained in the following subsections; additional unmeasured time was also spent by the chief of surgical services, the chief of surgical nursing, members of the ICU bed shortage task force (listed below), and members of the hospital's information management team.
Results
An important indicator of ICU performance is the extent that waiting times for requests known to require an ICU stay, from submission of a request until the procedure, are longer than they would be if there was an unlimited number of ICU beds. To measure this, the study measured patient waiting as a function of the hospital's functional ICU capacity. These measurements were performed for patients waiting for cardiac procedures known to require an ICU stay as a proxy for all operative procedures
Discussion
The goal of this study was to identify potential avenues for improving the performance of the ICU for surgical patients by reducing cancellation of operative procedures known to require ICU stays, reducing wait times for those procedures, and improving access to the ICU. While most ICUs in Canada and in many other parts of the world mix surgical and medical patients, it was felt that an important starting point for an analysis of the need for ICU beds for surgical patients should be with an ICU
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