We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A quality improvement study on how a simulation model can help decision making on organization of ICU wards.
- Authors
Sent, Danielle; van der Meulen, Delanie M.; Alban, Andres; Chick, Stephen E.; Wissink, Ilse J.A.; Vlaar, Alexander P.J.; Dongelmans, Dave A.
- 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.
- Subjects
DISCRETE event simulation; DECISION making; CRITICALLY ill patient care; SIMULATION methods &; models; INTENSIVE care units; HOSPITAL size
- Publication
BMC Health Services Research, 2024, Vol 24, Issue 1, p1
- ISSN
1472-6963
- Publication type
Article
- DOI
10.1186/s12913-024-11161-2