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Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact.
Crit Care 2013; 17(4):R128CC

Abstract

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.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23826830

Citation

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 (London, England), vol. 17, no. 4, 2013, pp. R128.
Johnson DW, Schmidt UH, Bittner EA, et al. Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact. Crit Care. 2013;17(4):R128.
Johnson, D. W., Schmidt, U. H., Bittner, E. A., Christensen, B., Levi, R., & Pino, R. M. (2013). Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact. Critical Care (London, England), 17(4), pp. R128. doi:10.1186/cc12807.
Johnson DW, et al. Delay of Transfer From the Intensive Care Unit: a Prospective Observational Study of Incidence, Causes, and Financial Impact. Crit Care. 2013 Jul 4;17(4):R128. PubMed PMID: 23826830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delay of transfer from the intensive care unit: a prospective observational study of incidence, causes, and financial impact. AU - Johnson,Daniel W, AU - Schmidt,Ulrich H, AU - Bittner,Edward A, AU - Christensen,Benjamin, AU - Levi,Retsef, AU - Pino,Richard M, Y1 - 2013/07/04/ PY - 2012/12/21/received PY - 2013/07/04/accepted PY - 2013/7/6/entrez PY - 2013/7/6/pubmed PY - 2015/3/31/medline SP - R128 EP - R128 JF - Critical care (London, England) JO - Crit Care VL - 17 IS - 4 N2 - 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. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/23826830/Delay_of_transfer_from_the_intensive_care_unit:_a_prospective_observational_study_of_incidence_causes_and_financial_impact_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc12807 DB - PRIME DP - Unbound Medicine ER -