Impact of staffing a surgical intermediate care unit with a critical care specialist
AIM To assess the impact of reorganising an 11-bed surgical intermediate care unit (IMCU) from an open to a semi-closed system in a Swiss University Hospital by adding a critical care specialist (CCS). METHODS This was a cohort study including adul...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2019-09-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2673 |
| _version_ | 1826997097860169728 |
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| author | Géraldine Paratte Tobias Zingg Valérie Addor Hélène Krief Markus Schäfer Nicolas Demartines |
| author_facet | Géraldine Paratte Tobias Zingg Valérie Addor Hélène Krief Markus Schäfer Nicolas Demartines |
| author_sort | Géraldine Paratte |
| collection | DOAJ |
| description |
AIM
To assess the impact of reorganising an 11-bed surgical intermediate care unit (IMCU) from an open to a semi-closed system in a Swiss University Hospital by adding a critical care specialist (CCS).
METHODS
This was a cohort study including adult IMCU patients enrolled in an Enhanced Recovery After Surgery protocol in the Department of Visceral Surgery, Lausanne University Hospital, from 1 February 2014 to 31 January 2016. Medical supervision by a CCS was implemented on 1 February 2015.
RESULTS
Introduction of a CCS in a surgical IMCU significantly reduced intensive care unit length of stay (p = 0.005) and potentially preventable operation (p = 0.04) for patients undergoing oesophageal surgery. A CCS in IMCU also proved to significantly reduce readmission in IMCU for hepatic surgery patients (p = 0.04). For other sub-specialties (colorectal, pancreatic and gastric bypass surgery) no significant difference could be found.
CONCLUSIONS
Reorganisation of a surgical IMCU from an open to a semi-closed system by implementing supervision by a CCS decreased length of stay and complications for the most fragile surgical patients (oesophageal and hepatic patients) after 12 months of implementation.
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| first_indexed | 2024-04-12T00:25:22Z |
| format | Article |
| id | doaj.art-5e504a36c5544e13a4c958069ca02cce |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:56:13Z |
| publishDate | 2019-09-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-5e504a36c5544e13a4c958069ca02cce2024-11-02T09:11:09ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972019-09-01149394010.4414/smw.2019.20117Impact of staffing a surgical intermediate care unit with a critical care specialistGéraldine Paratte0Tobias Zingg1Valérie Addor2Hélène Krief3Markus Schäfer4Nicolas Demartines5Department of Visceral Surgery, Lausanne University Hospital, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital, SwitzerlandDepartment of Geriatrics, Lausanne University Hospital, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital, Switzerland AIM To assess the impact of reorganising an 11-bed surgical intermediate care unit (IMCU) from an open to a semi-closed system in a Swiss University Hospital by adding a critical care specialist (CCS). METHODS This was a cohort study including adult IMCU patients enrolled in an Enhanced Recovery After Surgery protocol in the Department of Visceral Surgery, Lausanne University Hospital, from 1 February 2014 to 31 January 2016. Medical supervision by a CCS was implemented on 1 February 2015. RESULTS Introduction of a CCS in a surgical IMCU significantly reduced intensive care unit length of stay (p = 0.005) and potentially preventable operation (p = 0.04) for patients undergoing oesophageal surgery. A CCS in IMCU also proved to significantly reduce readmission in IMCU for hepatic surgery patients (p = 0.04). For other sub-specialties (colorectal, pancreatic and gastric bypass surgery) no significant difference could be found. CONCLUSIONS Reorganisation of a surgical IMCU from an open to a semi-closed system by implementing supervision by a CCS decreased length of stay and complications for the most fragile surgical patients (oesophageal and hepatic patients) after 12 months of implementation. https://www.smw.ch/index.php/smw/article/view/2673acute surgical patientsprofessionalisation of acute unitsemi-closed ICU |
| spellingShingle | Géraldine Paratte Tobias Zingg Valérie Addor Hélène Krief Markus Schäfer Nicolas Demartines Impact of staffing a surgical intermediate care unit with a critical care specialist Swiss Medical Weekly acute surgical patients professionalisation of acute unit semi-closed ICU |
| title | Impact of staffing a surgical intermediate care unit with a critical care specialist |
| title_full | Impact of staffing a surgical intermediate care unit with a critical care specialist |
| title_fullStr | Impact of staffing a surgical intermediate care unit with a critical care specialist |
| title_full_unstemmed | Impact of staffing a surgical intermediate care unit with a critical care specialist |
| title_short | Impact of staffing a surgical intermediate care unit with a critical care specialist |
| title_sort | impact of staffing a surgical intermediate care unit with a critical care specialist |
| topic | acute surgical patients professionalisation of acute unit semi-closed ICU |
| url | https://www.smw.ch/index.php/smw/article/view/2673 |
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