Sunday, July 16, 2006

Sunday July 16, 2006
Optimum patients' load for intensivist

ICUs in united stated range anywhere from 6 to 24 beds or may be more. At this point, it is not clear at what point intensivist's efficiency plateau out and effects the overall outcome.

Drs. Saqib Dara, MD and Bekele Afessa, MD from Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN looked into the issue with regression analyses of about 25,00 patients. They divided intensivits' patients load into 4 groups:

  • 1:7.5,
  • 1:9.5,
  • 1:12, and
  • 1:15

They found that the ICU period with one intensivist for 15 beds had a longer adjusted ICU LOS (length of stay). Although the ICU period with an intensivist-to-bed ratio of 1:7.5 had the shortest ICU LOS ratio, the difference was not statistically significant compared to the periods with intensivist-to-ICU bed ratios of 1:9.5 or 1:12.

This is the only study of its kind from single institution but it appears that optimum number of patients,
intensivist should carry to produce maximum outcome is around 12 or less.

It is all good work of intensivists' that observed ICU mortality did not differ significantly in any group despite progressive increase of load of work.

Reference: click to get article/abstract
Intensivist-to-Bed Ratio - Association With Outcomes in the Medical ICU - chest. 2005;128:567-572.