Beds in pediatric intensive care unit could be used more efficiently with improved flow

The pediatric intensive care unit (PICU) is a precious resource. With limited number of beds and resource-intensive services, it is a key component of patient flow. A new study published in the Journal of Hospital Medicine reveals that while a large PICU observed for the study delivered critical care services most of the time, periods of non-critical care services represented a barrier to access for new patients. At times when a bed was needed for a new patient, the PICU had beds being used for patients who could have been in other settings.

Led by Evan Fieldston, MD, MBA, MSHP, of the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, researchers conducted a real-time prospective observational study in a convenience sample of days in the PICU of an urban tertiary-care children's hospital.

Three trained observers spent 5 non-contiguous weeks in the PICU for 16 hours each day and also recorded what happened overnight each morning. This created over 20,000-bed-hours of data, which were then categorized as medical or nursing value-added, necessary logistics, non-value-added, or empty and unassigned time.

Results showed that 82% of the time, the beds were being used for value-added purposes. While only 8% of the time was non-value added, during 75% of the time when the PICU was full, at least 1 bed was being used for a non-value-added purpose and 37% of the time, that was 2 beds.

"This topic affects the delivery of healthcare in all settings, but most notably inpatient settings," Fieldston concludes. "This work is part of a larger stream that is merging operations management and other techniques to better describe and improve and provides hospitalists and hospital leaders an approach to learn more about their operations."

Andrew Auerbach, MD, MPH, Editor-in-Chief of the journal, notes "Intensive care services are scarce resources, and stewardship of critical care beds is crucially important. This study helps clinicians, patients, and hospital administrators by providing an understanding of where opportunities for improvement exist."

More information: Fieldston et al.Direct Observation of Bed Utilization in the Pediatric Intensive Care Unit. Journal of Hospital Medicine. DOI: 10.1002/jhm.993

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Ebola scare boosts business for US company

2 hours ago

The Ebola scare has subsided in the United States, at least temporarily, but an Alabama manufacturer is still trying to catch up with a glut of orders for gear to protect against the disease.

Thai parliament votes to ban commercial surrogacy (Update)

10 hours ago

Thailand's parliament has voted to ban commercial surrogacy after outrage erupted over the unregulated industry following a series scandals including the case of an Australian couple accused of abandoning a baby with Down's ...

Doctor behind 'free radical' aging theory dies

Nov 25, 2014

Dr. Denham Harman, a renowned scientist who developed the most widely accepted theory on aging that's now used to study cancer, Alzheimer's disease and other illnesses, has died in Nebraska at age 98.

Mexican boy who had massive tumor recovering

Nov 25, 2014

An 11-year-old Mexican boy who had pieces of a massive tumor removed and who drew international attention after U.S. officials helped him get treatment in the southwestern U.S. state of New Mexico is still recovering after ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.