ArticleIntensive care medicine2023
Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.
Article in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effects of Real-Time Automated Clinical Deterioration Alert and Trigger Systems on Clinical Outcomes in Adult General Ward Patients: A Systematic Review and Meta-Analysis.Critical care medicine · 2026Pooled it
- CARE-ATLANTIC: understanding cross cultural differences in goals of care; a transatlantic study in critical care medicine.BMC medical ethics · 2026Article
- Association Between Surgical Timing and Perioperative Outcomes in Lumbar Spine Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- A Machine Learning Model to Predict Post-Operative Intensive Care Unit Admission in Patients with Cancer Based on Clinical Characteristics and Hematologic Parameters Data.Journal of clinical medicine · 2026Article
- Article
- [Value judgments in the determination of a medical indication - An interdisciplinary analysis].Deutsche medizinische Wochenschrift (1946) · 2026Article
- Covert Triage During the COVID-19 Pandemic: A Qualitative Analysis of Rationing in Intensive Care.Chest · 2025Article
- Age and grit in prioritising intensive care: - a mixed-methods approach of normative challenges.BMC medical ethics · 2025Article
- Intensive care unit outcomes and prognostic factors of colorectal cancer.World journal of gastrointestinal oncology · 2025Article
- Phenomenological study on decision fatigue among surrogate decision-makers for ICU patients.Medicine · 2025Article
- Enhancing the Conversion of Patients from Outpatient to Inpatient Department: A Comprehensive Analysis.Journal of pharmacy & bioallied sciences · 2025Article
- Intensive care unit outcomes and prognostic factors of esophageal cancer: A cross-sectional study in Chinese cancer-specialized hospitals.World journal of gastrointestinal oncology · 2025Article
- Reliability and validity of a new postoperative track assessment tool (PoTra-tool) as a decision-making aid: A prospective observational study.European journal of anaesthesiology and intensive care · 2025Article
- Development and validation of a transformer model-based early warning score for real-time prediction of adverse outcomes in the emergency department.Scientific reports · 2025Article
- Association between emergency department to intensive care units time and in-hospital mortality: an analysis of the MIMIC-IV database.BMJ open · 2025Observational
- An Explanatory Mixed-Methods Study of Intensive Care Unit Net Benefit: Triage and Trajectory for Sepsis and Acute Respiratory Failure.Annals of the American Thoracic Society · 2025Article
- Mortality and Length of Stay Implications of Deterioration-Associated Transfer to the Intensive Care Unit over Different Time Frames.Health services insights · 2025Article
- Characteristics and outcomes of cancer patients admitted to intensive care units in cancer specialized hospitals in China.Journal of cancer research and clinical oncology · 2024Article
- Streamlining management in thoracic trauma: radiomics- and AI-based assessment of patient risks.Frontiers in surgery · 2024Article
- The current state of intensive care unit discharge practices - Results of an international survey study.Frontiers in medicine · 2024Article
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9 authors.
Funding
Abstract
purposeSome hospitals in the United States (US) use intensive care 20 times more than others. Since intensive care is lifesaving for some but potentially harmful for others, there is a need to understand factors that influence how intensive care unit (ICU) admission decisions are made.
methodsA qualitative analysis of eight US hospitals was conducted with semi-structured, one-on-one interviews supplemented by site visits and clinical observations.
resultsA total of 87 participants (24 nurses, 52 physicians, and 11 other staff) were interviewed, and 40 h were spent observing ICU operations across the eight hospitals. Four hospital-level factors were identified that influenced ICU admission decision-making. First, availability of intermediate care led to reallocation of patients who might otherwise be sent to an ICU. Second, participants stressed the importance of ICU nurse availability as a key modifier of ICU capacity. Patients cared for by experienced general care physicians and nurses were less likely to receive ICU care. Third, smaller or rural hospitals opted for longer emergency department patient-stays over ICU admission to expedite interhospital transfer of critically ill patients. Fourth, lack of clarity in ICU admission policies led clinicians to feel pressured to use ICU care for patients who might otherwise not have received it.
conclusionHealth care systems should evaluate their use of ICU care and establish institutional patterns that ensure ICU admission decisions are patient-centered but also account for resources and constraints particular to each hospital.
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