The clinical and operational consequences of prolonged occupancy strain and the use of non-intensive care beds to deliver critical care in a central london teaching hospital

A Mcloone,C Bell,T Chang,C Harrington,M Dowling,S Ward,A Feehan,K Peters,H Little,Pa Hopkins

doi:10.1186/2197-425x-3-s1-a477

A Mcloone, C Bell + Show 8 more

Open Access

https://doi.org/10.1186/2197-425x-3-s1-a477

Copy DOI

Abstract

Since 2000, there has been a marked reduction in non-clinical critical care transfers in England. ICNARC have reported that this has been associated with a reduction in case-mix adjusted mortality (1). One consequence has been the need to open critical care beds in non-specified locations in hospitals such as post anaesthesia recovery and high dependency areas. Here we report the consequences of an unprecedented strain on ICU capacity sustained at a central London teaching hospital over a 12 month period in 2013 (graph 1). During this period, ICU capacity reached >150% requiring a number of different emergent solutions including the use of main theatre recovery and high dependency areas. We also describe some of the clinical and operational lessons we learnt.

Highlights

Since 2000, there has been a marked reduction in nonclinical critical care transfers in England
We report the consequences of an unprecedented strain on ICU capacity sustained at a central London teaching hospital over a 12 month period in 2013
ICU capacity reached >150% requiring a number of different emergent solutions including the use of main theatre recovery and high dependency areas

Summary

Introduction

Since 2000, there has been a marked reduction in nonclinical critical care transfers in England. ICNARC have reported that this has been associated with a reduction in case-mix adjusted mortality (1). One consequence has been the need to open critical care beds in non-specified locations in hospitals such as post anaesthesia recovery and high dependency areas. We report the consequences of an unprecedented strain on ICU capacity sustained at a central London teaching hospital over a 12 month period in 2013 (graph 1). During this period, ICU capacity reached >150% requiring a number of different emergent solutions including the use of main theatre recovery and high dependency areas. We describe some of the clinical and operational lessons we learnt

Objectives

Results

Conclusion