Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact
Introduction: A paucity of literature exists regarding delays in transfer out of the intensive care unit. We sought to analyze the incidence, causes, and costs of delayed transfer from a surgical intensive care unit (SICU). Methods: An IRB-approved prospective observational study was conducted fr...
| Main Authors: | , , , , , |
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| Other Authors: | |
| Format: | Article |
| Language: | English |
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BioMed Central Ltd
2013
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| Online Access: | http://hdl.handle.net/1721.1/80292 https://orcid.org/0000-0002-1994-4875 |
| _version_ | 1826217215745064960 |
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| author | Johnson, Daniel W. Schmidt, Ulrich H. Bittner, Edward A. Christensen, Benjamin Levi, Retsef Pino, Richard M. |
| author2 | Sloan School of Management |
| author_facet | Sloan School of Management Johnson, Daniel W. Schmidt, Ulrich H. Bittner, Edward A. Christensen, Benjamin Levi, Retsef Pino, Richard M. |
| author_sort | Johnson, Daniel W. |
| collection | MIT |
| description | Introduction:
A paucity of literature exists regarding delays in transfer out of the intensive care unit. We sought to analyze the incidence, causes, and costs of delayed transfer from a surgical intensive care unit (SICU).
Methods:
An IRB-approved prospective observational study was conducted from January 24, 2010, to July 31, 2010, of all 731 patients transferred from a 20-bed SICU at a large tertiary-care academic medical center. Data were collected on patients who were medically ready for transfer to the floor who remained in the SICU for at least 1 extra day. Reasons for delay were examined, and extra costs associated were estimated.
Results:
Transfer to the floor was delayed in 22% (n = 160) of the 731 patients transferred from the SICU. Delays ranged from 1 to 6 days (mean, 1.5 days; median, 2 days). The extra costs associated with delays were estimated to be $581,790 during the study period, or $21,547 per week. The most common reasons for delay in transfer were lack of available surgical-floor bed (71% (114 of 160)), lack of room appropriate for infectious contact precautions (18% (28 of 160)), change of primary service (Surgery to Medicine) (7% (11 of 160)), and lack of available patient attendant ("sitter" for mildly delirious patients) (3% (five of 160)). A positive association was found between the daily hospital census and the daily number of SICU beds occupied by patients delayed in transfer (Spearman rho = 0.27; P < 0.0001).
Conclusions:
Delay in transfer from the SICU is common and costly. The most common reason for delay is insufficient availability of surgical-floor beds. Delay in transfer is associated with high hospital census. Further study of this problem is necessary. |
| first_indexed | 2024-09-23T16:59:50Z |
| format | Article |
| id | mit-1721.1/80292 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T16:59:50Z |
| publishDate | 2013 |
| publisher | BioMed Central Ltd |
| record_format | dspace |
| spelling | mit-1721.1/802922022-09-29T22:58:27Z Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact Johnson, Daniel W. Schmidt, Ulrich H. Bittner, Edward A. Christensen, Benjamin Levi, Retsef Pino, Richard M. Sloan School of Management Schmidt, Ulrich H. Christensen, Benjamin Levi, Retsef Introduction: A paucity of literature exists regarding delays in transfer out of the intensive care unit. We sought to analyze the incidence, causes, and costs of delayed transfer from a surgical intensive care unit (SICU). Methods: An IRB-approved prospective observational study was conducted from January 24, 2010, to July 31, 2010, of all 731 patients transferred from a 20-bed SICU at a large tertiary-care academic medical center. Data were collected on patients who were medically ready for transfer to the floor who remained in the SICU for at least 1 extra day. Reasons for delay were examined, and extra costs associated were estimated. Results: Transfer to the floor was delayed in 22% (n = 160) of the 731 patients transferred from the SICU. Delays ranged from 1 to 6 days (mean, 1.5 days; median, 2 days). The extra costs associated with delays were estimated to be $581,790 during the study period, or $21,547 per week. The most common reasons for delay in transfer were lack of available surgical-floor bed (71% (114 of 160)), lack of room appropriate for infectious contact precautions (18% (28 of 160)), change of primary service (Surgery to Medicine) (7% (11 of 160)), and lack of available patient attendant ("sitter" for mildly delirious patients) (3% (five of 160)). A positive association was found between the daily hospital census and the daily number of SICU beds occupied by patients delayed in transfer (Spearman rho = 0.27; P < 0.0001). Conclusions: Delay in transfer from the SICU is common and costly. The most common reason for delay is insufficient availability of surgical-floor beds. Delay in transfer is associated with high hospital census. Further study of this problem is necessary. Massachusetts General Hospital. Dept. of Anesthesia and Critical Care 2013-08-27T13:27:53Z 2013-08-27T13:27:53Z 2013-07 2013-05 2013-08-20T11:04:27Z Article http://purl.org/eprint/type/JournalArticle 1364-8535 1875-7081 http://hdl.handle.net/1721.1/80292 Johnson, Daniel W et al. “Delay of Transfer from the Intensive Care Unit: a Prospective Observational Study of Incidence, Causes, and Financial Impact.” Critical Care 17.4 (2013): R128. https://orcid.org/0000-0002-1994-4875 en http://dx.doi.org/10.1186/cc12807 Critical Care Creative Commons Attribution http://creativecommons.org/licenses/by/2.0 Daniel W Johnson et al.; licensee BioMed Central Ltd. application/pdf BioMed Central Ltd BioMed Central Ltd |
| spellingShingle | Johnson, Daniel W. Schmidt, Ulrich H. Bittner, Edward A. Christensen, Benjamin Levi, Retsef Pino, Richard M. Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact |
| title | Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact |
| title_full | Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact |
| title_fullStr | Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact |
| title_full_unstemmed | Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact |
| title_short | Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact |
| title_sort | delay of transfer from the intensive care unit a prospective observational study of incidence causes and financial impact |
| url | http://hdl.handle.net/1721.1/80292 https://orcid.org/0000-0002-1994-4875 |
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