Critical Care Services Research Articles

ICU-Managed Patients' Epidemiology, Characteristics, and Outcomes: A Retrospective Single-Center Study.

Resources are limited, and it is exceedingly difficult to provide intensive care in developing nations. In Somalia, intensive care unit (ICU) care was introduced only a few years ago. In this study, we aimed to determine the epidemiology, characteristics, and outcome of ICU-managed patients in a tertiary hospital in Mogadishu. We retrospectively evaluated the files of 1082 patients admitted to our ICU during the year 2021. The majority (39.7%) of the patients were adults (aged between 20 and 39 years), and 67.8% were male patients. The median ICU length of stay was three days (IQR = 5 days), and nonsurvivors had shorter stays, one day. The mortality rate was 45.1%. The demand for critical care services in low-income countries is high. The country has a very low ICU bed capacity. Critical care remains a neglected area of health service delivery in this setting, with large numbers of patients with potentially treatable conditions not having access to such services.

Intensive Care Nurses' Experience of Caring in Greece; A Qualitative Study.

Whilst nurses and critical care services have been at the forefront of the COVID-19 pandemic, it has become more apparent that intensive care nurses are presented with challenging ethical and clinical decisions and are required to care for individuals with critical illnesses under high-pressure conditions. This is not a new phenomenon. The aim of this study, which was conducted before the outbreak of COVID-19, was to explore the experience of caring through the narratives of intensive care nurses in Greece. A qualitative study was conducted through in-depth, semi-structured interviews with nineteen ICU nurses in Athens. Transcripts were subjected to Braun and Clarke's thematic analysis and organised with Atlas.ti v8 QDA software. The intensive care nurses' experience of caring in Greece encompassed four themes: (A) being "proximal", "co-present" and caring with empathy, (B) being "responsible" for your patient and negotiating with the doctors, (C) technology and "fighting with all you've got", and (D) "not being kept informed" and disappointment. The narratives of this study highlight that ICU nurses in Greece provide patient-centred and compassionate care. Nurse leaders should develop appropriate healthcare policies so as to ensure the adequate provision of staff, specialist education, and support to nurses working in critical care. Failure to address these issues may lead to poor quality of care and negative patient outcomes.

Factors Influencing Pre-Cardiopulmonary Arrest Signs among Post-General Surgery Patients in Critical Care Service System

Health service system factors can lead to pre-cardiopulmonary arrest signs (pre-CA), which refer to a critical condition in the body leading to a circulatory and respiratory system disruption. The purpose of this study was to assess the incidence rate of an event leading to pre-cardiopulmonary arrest signs within the first 24 h, and also to analyze the factors influencing the health service system in critical post-general surgery patients in the intensive care unit. These results of the study found the incidence rate of pre-CA was 49.05 per 1000 person-hours, especially 1 h after admission to the ICU. Hemodynamic instability, respiratory instability, and neurological alteration were the most common pre-CA symptoms. The patient factors associated with high pre-CA arrest sign scores were the age from 18-40 years, with an operation status as emergency surgery, elective surgery compared with urgent surgery, and the interaction of operation status and age in critical post-general surgery patients. The organization factors found advanced hospital level and nurse allocation were associated with pre-CA. To improve quality of care for critical post-general surgery patients, critical care service delivery should be delegated to nurses with nurse allocation and critical care nursing training. Guidelines must be established for critically ill post-general surgery patient care.

Effect of Anesthesia Intensive Care Unit during the COVID-19 Pandemic

With the rapid development of anesthesiology, anesthesiologists have accumulated rich clinical experience in rescuing critically ill patients. Anesthesia intensive care unit (AICU) is a specific hospital area that is managed and organized by the anesthesiology and critical care service. AICU offers multidisciplinary care for critically ill patients in the perioperative period through a team of specialists, predominantly anesthesiologists. By the end of 2022, the surge of Coronavirus Disease 2019 (COVID-19) cases has overwhelmed the healthcare services in our country. Medical staff in the AICU leveraged their expertise to provide accurate monitoring and timely symptomatic treatment to ill patients with COVID-19 infection and promoted the rehabilitation of patients.

For-Profit Hospital Reflections on Community Relationships in the Time of COVID-19.

Throughout the COVID-19 pandemic, hospitals and their staffs have been pushed to their limits. Hospitals have had to rethink how they support community health while also providing critical acute care services to combat the morbidity and mortality associated with COVID-19. As anchor institutions, hospitals have a significant effect on not only community health and well-being but also on local economies as primary employers and contractors. This study aimed to understand how the pandemic reshaped interactions with community members, staff, and other community organizations and changed the nature of hospital-community engagement among for-profit hospitals. We recruited leaders of for-profit hospitals, systems, and a business association that represents for-profit hospitals. We interviewed 28 participants in various leadership roles via telephone or videoconferencing and then thematically coded interview transcriptions. The themes identified in early interviews guided the structure of forthcoming interviews. For-profit hospitals appear motivated to address community health needs as anchor institutions in their communities, and these efforts have strengthened and changed in important ways as a result of the COVID-19 pandemic. In this study, three themes emerged regarding the influence of COVID-19 on hospital-community relationships: Hospitals refocused outreach and engagement efforts to support employees, found essential new ways to safely engage with the community through partnerships and collaborations, and were reminded of the critical roles of social and cultural factors in the health and well-being of individuals and communities. Hospitals may be able to use lessons learned during the pandemic to support the growing need for community engagement and attention to social determinants of health. The themes that emerged from this study present valuable opportunities for hospitals to carry forward the lessons learned over the course of the pandemic, as they have the potential to improve the delivery of healthcare and community engagement in day-to-day operations as well as in crises.

Analysis of Hospital Based Urine Drug Screening Tests over 2 Years. Does it Mirror the Actual Prevalence of Drug Abuse!

Effect of drugs often interplays with the diagnosis and treatment of patients presenting to Emergency and critical care services of the hospital. Urine drug screen (UDS) is a qualitative toxicological screening tool which is simple, fast and has a relatively low cost providing a clue in acute care settings. The present study aims to determine the prevalence of drugs of abuse determined by UDS in suspected patients in a hospital set up and compare it to national prevalence study. It is a retrospective study conducted in the Toxicology lab in KIMS Medical College and Hospital, in Odisha over a period of 30 months where urine samples received from the hospital were included. Commonly abused substances were detected by urine drug screen by the help of a commercially available lateral flow assay kit. We received 232 samples in this study period of which 108 (46.5%) tested positive by urine drug screen.The highest positivity among the samples was noted in the age group of 21-30 (33.3%) closely followed by 11-20 (30.6%) with a male preponderance.(32.3%) cases where single drug was found in urine drug screen while 33 (14.2%) of cases had multiple drugs detected in the UDS. Most common substance of abuse was benzodiazepines in 43.2% cases. THC (29.05%) and OPI (14.2%) were the other commonly abused drugs. In poly drug abusers, commonest drug combination consisted of OPI and THC with or without BZO in 36.36 % (12 /33) cases. Thus, in spite of having many limitation of urine drug screen will help in the acute patient care set up particularly for diagnosis of poly drug abuse.

Adolescent Drug Ingestions Requiring ICU Stay: Single-Center Retrospective Cohort Study.

Ingestions are a prevalent form of self-harm in teenagers and are unfortunately an increasingly common reason for admission to both acute care and critical care services. The goal of this study was to identify characteristics associated with requiring PICU stay among adolescents hospitalized for ingestions. Retrospective cohort study comparing patients admitted to hospital medicine service and critical care service from January 2019 to December 2019. Freestanding children's hospital in the midwestern United States. Adolescents 12-18 years old hospitalized for ingestion. None. Out of 209 patients included in the study cohort, 95 required PICU admission. High-risk behaviors (having had sex or usage of alcohol, drugs, tobacco, or vaping) were endorsed by 190 of 209 patients (91%). We compared patient characteristics, ingestion history, workup, and pharmacological and PICU-specific interventions between patients hospitalized on the hospital medicine service and the PICU. We failed to identify an association between reason for ingestion, substance ingested, and previously identified suicide risk factors including previous suicide attempt, previous self-harm, and psychiatric comorbidity and admission to PICU, as opposed to non-PICU admission. PICU stay was associated with longer peak corrected QT interval value, receiving a pharmacological intervention, and longer duration of hospital stay. Fifteen of 95 patients (16% [95% CI, 9-25%]) in the PICU received a PICU-specific intervention. We failed to identify specific patient demographics or mental behavioral health characteristics associated with PICU stay after ingestion. Therefore, we believe that all adolescents hospitalized due to ingestion-irrespective of disposition-should receive standardized high-risk behavior screening due to the pervasive nature of these behaviors among this patient population. PICU-specific care, beyond observation, could be needed in as high as one-in-four PICU admissions. Further research is needed to inform optimal disposition and resource allocation for this patient population.

CHARACTERISTICS OF HOSPITALS AND PROVIDER MARKETS ASSOCIATED WITH INCREASES IN HOME HEALTH CARE USE

Abstract Many older adults require post-acute care from a nursing home or home health agency following hospitalization. Recent trends show providers are increasingly relying on home health agencies rather than institutionalized settings, with home health volume surpassing skilled nursing facility (SNF) volume since 2017. Using MedPAR patient encounter data from 2016–2019 and provider data from CMS, we analyze changes in the profile of patients receiving home health over time, showing that individuals discharged to home health are increasing in complexity based on hospital length of stay, comorbidities, and use of critical care services. Mixed effects models additionally suggest that grouping patients at the hospital and market level helps to account for unexplained variation in whether a patient is likely to receive home health versus SNF services. Examining the characteristics of hospitals and provider markets with increasing rates of home health referrals over time, we found that hospitals with increasing rates of discharge to home health were more likely to be for-profit facilities in urban areas with higher operating margins. However, this increase was not consistently tied to a corresponding decrease in rates of discharge to SNF, suggesting that hospitals are experiencing a combination of both patient-shifting across post-acute settings as well as an overall increase in baseline complexity of hospitalized patients over this time period. These results have implications for understanding the how policies currently being considered to improve value in the post-acute sector filter through heterogeneous market structures and complex organizational environments to impact patient care decisions.

Analyzing the Role of Service Congestion in Accessibility Modeling

An important variable in measuring potential access is the competitive nature of the service being provided. Health services such as physician visits or hospital beds are often viewed as rival goods where one’s consumption of a service will diminish another’s ability to consume the same service. Congestion at facilities is as important as the overall level of supply at facilities. For rival goods, accessibility and congestion are linked as reciprocal concepts. The relationship between accessibility and congestion is even more important in the current era of the COVID-19 pandemic because critical care services, such as the need for intensive care unit beds, illustrate the need to focus on a balanced level of congestion among hospitals to prevent care failure at the local level. This research investigates the role of service congestion in various existing and proposed models and measures using data from the state of Illinois. Because evenness of service congestion and lower travel times are conflicting goals, evenness of congestion as measured by Gini coefficients is weighed against the cost of travel to determine a compromise solution. Results suggest that the rational agent access model and the congested supply accessibility model provide such compromises when used in conjunction with the transportation problem.

959: TRACHEOSTOMY IN PEDIATRIC ONCOLOGY AND HEMATOPOIETIC STEM CELL TRANSPLANT POPULATIONS

Introduction: Children with oncologic diagnoses and those who undergo hematopoietic stem cell transplantation (HSCT) have infrequent but high intensity utilization of critical care services, including need for prolonged mechanical ventilation (MV). While tracheostomy has been shown to be a safe procedure with increasing incidence in other pediatric populations, there is no overall consensus on optimal timing, patient selection, or relative contraindications. This study describes the HSCT and oncology cohorts from multiple pediatric centers who underwent tracheostomy. Methods: The Pediatric Health information System database (2009-2020) was used for a retrospective, descriptive cohort study of all patients with an oncologic diagnosis and/or SCT code and underwent tracheotomy. Results: 1,061 patients were included, 217 (20%) of whom had undergone HSCT. The annual incidence in tracheostomy did not change significantly over the study period. The majority (62%) underwent tracheostomy early (< 30 days) in the admission. Complications reported included tracheostomy site bleeding (< 1%) and infection (24%). The overall rate of MV at discharge was 26% and was significantly associated with preexisting chronic lung disease (adjusted odds ratio [OR] 2.1; 95% CI 1.19- 3.7), and acute lung disease ([OR] 1.63; 95% CI 1.12-2.35). Those who underwent the procedure late (>90 days) had a significant increase in MV at discharge (52% vs 25%, p< 0.001) and in hospital mortality (53% vs 18%, p< 0.001) compared to the early subgroup. The overall rate of mortality was 28% within the cohort and significantly associated with HSCT ([OR] 2.04; 95% CI 1.17- 3.56), diagnosis of sepsis ([OR] 2.09; 95% CI 1.36- 3.19), and requirement for renal replacement therapy ([OR] 2.86; 95% CI 1.71- 4.79). Conclusions: This is the first study describing pediatric oncology and HSCT patients who undergo tracheostomy. Despite implicit concerns for immunocompromised or thrombocytopenic status, complication rates are not disproportionate. Significantly higher need for MV at discharge and mortality, however, is seen in patients who undergo the procedure late in a hospitalization, with certain chronic conditions. and other ICU specific comorbidities. Further understanding of this vulnerable cohort, however, is needed to inform timing and patient selection.

318: NONALCOHOLIC FATTY LIVER DISEASE ASSOCIATION WITH HOSPITAL AND ICU ADMISSION IN COVID-19

Introduction: Association between non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD) with COVID-19 is still an ongoing debate. We aimed to conduct a systematic review and meta-analysis investigating the impact of NAFLD/ MAFLD on the duration of ICU and hospital stay in COVID-19 patients. Methods: A systematic review of literature from January 2019- to June 2022 on databases PubMed, Cochrane, Embase, Science Direct, and Web of science was conducted. Observational studies or clinical trials were included. Studies that assessed NAFLD/ MAFLD using lab assessment, non-invasive imaging, or liver biopsy were included. The protocol of the study was registered in Prospero and Prisma guidelines were followed (Figure 1). The meta-analysis was performed using Revman software. Mantel-Haenszel odds ratio was generated to describe the overall effect size using random effect models. Results: ICU Admission A total of 37,109 patients from fifteen studies were included in the qualitative analysis. A total of 5624 patients were in the NAFLD group and 31,485 patients were in the Non-NAFLD group, where 3148 patients with COVID-19 required ICU admission. Out of these, 1098 (19.5%) were in the NAFLD group and 2050 (6.5%) in the Non-NAFLD group. We observed a significantly increased ICU admission among COVID-19 patients with NAFLD compared to those without NAFLD (OR 1.67, 95%CI 1.02-2.72, p-value= 0.04). (Figure 2). Hospital Admission A total of 27,683 patients from three studies were included in the qualitative analysis. A total of 1128 patients in the NAFLD group and 26,555 patients in the Non-NAFLD group, where 4019 patients with COVID-19 required hospital admission. Out of these, 518 (45.9%) were in the NAFLD group and 3501(13.1%) in the Non-NAFLD group. We observed a significant increase in hospital admissions among COVID-19 patients with NAFLD compared to those without NAFLD (OR 2.71, 95%CI 1.10-6.70, p-Value=0.03). Conclusions: The NAFLD patients may have increased ICU and hospital admission compared to Non-NAFLD Patients. Fatty liver disease has an association with increased healthcare admission and critical care service utilization among COVID-19 patients.

Impact of the COVID-19 pandemic on critical care utilization in Japan: a nationwide inpatient database study

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has disrupted critical care services worldwide. Examining how critical care systems responded to the COVID-19 pandemic on a national level will be useful in setting future critical care plans. The present study aimed to describe the utilization of critical care services before and during the COVID-19 pandemic using a nationwide Japanese inpatient administrative database.MethodsAll patients admitted to an intensive care unit (ICU) or a high-dependency care unit (HDU) from February 9, 2019, to February 8, 2021, in the Japanese Diagnosis Procedure Combination inpatient database were included. February 9, 2020, was used as the breakpoint separating the periods before and during COVID-19 pandemic. Hospital and patient characteristics were compared before and during the COVID-19 pandemic. Change in ICU and HDU bed occupancy before and during the COVID-19 pandemic was evaluated using interrupted time-series analysis.ResultsThe number of ICU patients before and during the COVID-19 pandemic was 297,679 and 277,799, respectively, and the number of HDU patients was 408,005 and 384,647, respectively. In the participating hospitals (383 ICU-equipped hospitals and 460 HDU-equipped hospitals), the number of hospitals which increased the ICU and HDU beds capacity were 14 (3.7%) and 33 (7.2%), respectively. Patient characteristics and outcomes in ICU and HDU were similar before and during the COVID-19 pandemic except main etiology for admission of COVID-19. The mean ICU bed occupancy before and during the COVID-19 pandemic was 51.5% and 47.5%, respectively. The interrupted time-series analysis showed a downward level change in ICU bed occupancy during the COVID-19 pandemic (− 4.29%, 95% confidence intervals − 5.69 to − 2.88%), and HDU bed occupancy showed similar trends. Of 383 hospitals with ICUs, 232 (60.6%) treated COVID-19 patients in their ICUs. Their annual hospital case volume of COVID-19 ICU patients varied greatly, with a median of 10 (interquartile range 3–25, min 1, max 444).ConclusionsThe ICU and HDU bed capacity did not increase while their bed occupancy decreased during the COVID-19 pandemic in Japan. There was no change in clinicians’ decision-making to forego ICU/HDU care for selected patients, and there was no progress in the centralization of critically ill COVID-19 patients.

Characteristics and outcomes of patients triaged as critically ill in the emergency department of a tertiary care hospital in Bhutan

BackgroundIn Bhutan, where the Emergency Medical System is forming and evolving, the number of acutely ill patients requiring critical care, both in the emergency departments and intensive care units, is steadily increasing. Given the lack of baseline data and the ever-increasing number of critical care patients, this study was aimed at describing the characteristics and outcomes of patients triaged as critically ill in the emergency department.MethodsAn observational study was conducted over a yearlong period in the emergency department where all patients triaged as critically ill were approached for inclusion in the study. A case record form was used for the purpose of data collection. Epidata analysis was used for descriptive analysis and SPSS was used for binary logistic regression.ResultsA total of 657 critically ill patients of all age groups visited the emergency department over the 1-year study period, with adults constituting the majority (81%). The majority (67%) of these patients had a favorable outcome of surviving to discharge. The most common diagnosis among critically ill neonates was neonatal sepsis. Among the critically ill pediatrics and adults, sepsis, respiratory illnesses, and trauma were the most common diagnoses. Intubation followed by mechanical ventilation and blood product transfusion were the most common lifesaving interventions performed on critically ill patients.ConclusionThe findings from this study constitute the first ever local database, at the national referral hospital in Bhutan, of critically ill patients treated in the emergency department. It highlights the central role the emergency department plays in their management and provides information for strengthening critical care services. It also highlights the areas of improvement and identifies high yield areas of training for the emergency department.

Drug utilization in patients with SARS-CoV-2 in an intensive care unit

Context: Prescription indication studies allow identifying the problems that arise during the use of the drug. Aims: To evaluate the treatments used in patients diagnosed with SARS-CoV-2 infection hospitalized in critical care service, through a prescription indication study. Methods: A longitudinal observational study of medication use of the indication-prescription type with elements of the therapeutic scheme and practical consequences was carried out. The sample was characterized from the sociodemographic, clinical, and pharmacotherapeutic points of view. The prescription was evaluated through the indicators: indication, therapeutic scheme, treatment individualization, and drug combinations. The detected adverse reactions were classified according to their causality by the Naranjo Algorithm, their severity, their clinical significance, and according to their mechanism by Rawlins and Thompson. Results: In the sample (n = 77), the male gender predominated (79%) between 27-59 years old (64%), alcohol consumer (62%), hypertensive (33%) with long hospital stay (51%). A total of 417 medications were analyzed, being antibiotics (50.6%) the most prescribed. 73.4% of the therapeutic schemes were correct; however, 26.6% had problems with the therapeutic schemes due to incorrect doses, intervals, duration of treatment, and risky interactions. According to Rawlins and Thompson, two probable adverse reactions were detected, mild, non-serious, and type A and B. Conclusions: The results obtained will allow the pharmaceutical professional to create risk matrices that guarantee a timely intervention in the health team to contribute to the rational and safe use of medicines in patients infected with SARS-CoV-2.

Resource use, availability and cost in the provision of critical care in Tanzania: a systematic review

ObjectivesCritical care is essential in saving lives of critically ill patients, however, provision of critical care across lower resource settings can be costly, fragmented and heterogenous. Despite the urgent need...

Preparing for 2023: Emergency Department Visits

This article reviews changes to codes and guidelines for reporting evaluation and management (E/M) services provided to patients in an emergency department (ED), including the following: How codes are changingCode selection based on medical decision-making (MDM) aloneReporting ED E/M and critical care services on the same dateObservation services provided in the ED

The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa.

Paediatric intensive care, a valuable resource that improves the outcomes of critically ill children, is often scarce. To evaluate the need for paediatric intensive care beds and compare the outcomes of admitted and non-admitted deserving cases. A prospective evaluation of all bed requests, in terms of need for intensive care and outcomes of those admitted and not admitted to a paediatric intensive care unit (PICU), was performed between July 2017 and June 2018. Factors for refusal and for poor outcomes were evaluated. Of the 811 bed requests, 32.6% (n=264, p<0.001) were denied access. Of the 231 deserving cases who were denied access, 85.7% (n=198) were due to unavailability of a PICU bed. Patients not admitted to PICU had a twofold increased risk of dying compared with those admitted (34.4% v. 15.5% respectively, p<0.001), even though the patient characteristics of both groups were similar (age, gender and nutritional status). In those admitted, risk factors for mortality were requiring transfusion of blood and platelets (56.0%, p<0.001), requiring two or more inotropes (52.5%, p<0.001), instability on admission (41.3%, p<0.001), prior cardiac arrest (32.0%, p=0.021), severe acute malnutrition (26.9%, p=0.043), fungal infection (22.2%, p=0.004) and emergency admission (18.0%, p<0.001). In those not admitted, prior cardiac arrest (100%, p<0.001) and emergency referral (42.3%, p<0.001) were associated with adverse outcomes. The need for PICU beds exceeds availability, with a consequent twofold increase in mortality among cases not admitted to PICU. Paediatric critical care services have increased at appropriate sites of need following completion of this study.

Centralization of Pediatric Critical Care Services-It Seems to Work in Australia and New Zealand. Is It Right for All?

Centralization of Pediatric Critical Care Services-It Seems to Work in Australia and New Zealand. Is It Right for All?

Critical care bed capacity of Bangladesh: A Pre and Post COVID-19 pandemic survey

Background: Intensive care unit (ICU) is the backbone of critical care service delivery in a hospital. Bangladesh has been lagging behind in critical care service delivery since first ICU was established in 1978. In 2017-19 an international study reported that Bangladesh had 0.7 Critical care (ICU and HDU) bed per one lac population. This was quite low compared to South Asian countries. Growth of critical care beds across our country has been reported to be heterogeneous. The aim of this survey is to determine current strength and growth of critical care beds before the beginning of recent COVID pandemic and also at the height of pandemic when additional COVID ICUs and HDUs were introduced. Method: Data on number of ICUs and HDUs and their bed strength were obtained from different web sites of Govt. of Bangladesh as well through personal communication. Number of critical care beds were calculated at national and district level as number per one lac population. Ratio of critical care beds expressed in percentage with number of hospital beds in the hospital were calculated at national level. Data were also obtained on COVID ICU and HDU beds which were introduced temporarily from websites of ministry of Health, Govt. of Bangladesh. Results: As of now we documented (pre COVID pandemic) 2139 ICU beds (965 in Govt. hospitals) and 717 HDU beds (315 in Govt. hospitals) among 208 hospitals (Govt. hospitals 79+ Private hospitals 129) during our survey. Number of critical care beds per one lac population across the country is found to be 1.70. In hospitals with critical care beds the average ratio of critical care beds (ICU+HDU) beds compared to hospital beds is 4.34% across the country. Thirty eight of total 64 districts have no critical care facility (non COVID/pre COVID) in their local hospitals. During peak of pandemic Govt. of Bangladesh introduced and approved 1186 COVID ICU beds, 695 COVID HDU beds both at Govt. and private level on temporary basis in different hospitals including in some critical care deprived hospitals. Conclusion: Our survey concludes that growth and distribution of critical care beds (ICUS + HDUs) across Bangladesh is still heterogeneous and very much inadequate compared to the critical care need of the population. There was a temporary surge of new ICUs and HDUs to serve COVID patients at the height of COVID pandemic across the country. Health care planners of the country need to plan for developing adequate critical care man power as well as establish newer critical care facilities among existing hospitals who lack them. Bangladesh Crit Care J September 2022; 10(2): 88-98

Factors Affecting In Quality Of Healthcare Services In Critical Care Departments Of General Hospitals

Background: Healthcare organizations strive for quality in their service delivery as a way of keeping up with the competing trends in clients’ attraction. In the process, they have become cognizant of the key performance indicators to help track progress and performance. Despite the growing interests in healthcare KPIs, little has been done in terms of KPIs in the general hospitals, especially in the critical care units. Therefore, this study was designed to assess the implications of KPIs on the quality of healthcare service delivery in the critical care department in a general hospital in the Kingdom of Saudi Arabia.&#x0D; Methods: Quantitative descriptive quantitative research was conducted a among 300 healthcare workers in the critical care unit of a general hospital in Saudi Arabia. Data was collected after receiving ethical approval and participants’ consent. Accordingly, the researcher administered the questionnaires to the selected participants using a pre-made research questionnaire using the 5-point Likert scale. The collected data was analyzed using linear regression and the descriptive statistical tests of SPSS, version 26.&#x0D; Results: From the descriptive statistical analysis, two key performance indictors outstood in the critical care department of general hospitals. These include experiences with hospital staff (mean=3.143; SD =2.00) and Patient Readmission Rate (mean=3.106; SD=1.419). A statistically significant relationship was also noted between patient readmission rate (p=.030), experiences with hospital staff (p=.070) and staff's commitment to patients (p=.016) and the quality of critical care care services.&#x0D; Conclusion: Key performance indicators are crucial in tracking the milestones made in healthcare organizations towards meeting patients’ needs. Healthcare system management need to develop a means of tracking their key performance indicators for informed improvements in quality of their services.