Evidence map›Paper›PMID 38840245›Full record

ArticleBMC health services research2024

A quality improvement study on how a simulation model can help decision making on organization of ICU wards.

Danielle Sent, Delanie M van der Meulen, Andres Alban, Stephen E Chick, Ilse J A Wissink, Alexander P J Vlaar, Dave A Dongelmans

Abstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Danielle SentDepartment of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands. d.sent@tue.nl.ORCID http://orcid.org/0000-0002-4703-5345
Delanie M van der MeulenDepartment of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-1678-2057
Andres AlbanManagement Department, Frankfurt School of Finance & Management, Frankfurt am Main, Germany.ORCID http://orcid.org/0000-0002-9552-4039
Stephen E ChickTechnology and Operations Management, INSEAD, Fontainebleau, France.ORCID http://orcid.org/0000-0002-8026-1571
Ilse J A WissinkDepartment of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-5551-9868
Alexander P J VlaarDepartment of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-3453-7186
Dave A DongelmansDepartment of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-8477-6671

Funding

European Union MSCA-ESA-ITN project (676129)INSEAD Novartis Chair of Healthcare Management
6 · The paper itself

Abstract

backgroundIntensive Care Unit (ICU) capacity management is essential to provide high-quality healthcare for critically ill patients. Yet, consensus on the most favorable ICU design is lacking, especially whether ICUs should deliver dedicated or non-dedicated care. The decision for dedicated or non-dedicated ICU design considers a trade-off in the degree of specialization for individual patient care and efficient use of resources for society. We aim to share insights of a model simulating capacity effects for different ICU designs. Upon request, this simulation model is available for other ICUs.

methodsA discrete event simulation model was developed and used, to study the hypothetical performance of a large University Hospital ICU on occupancy, rejection, and rescheduling rates for a dedicated and non-dedicated ICU design in four different scenarios. These scenarios either simulate the base-case situation of the local ICU, varying bed capacity levels, potential effects of reduced length of stay for a dedicated design and unexpected increased inflow of unplanned patients.

resultsThe simulation model provided insights to foresee effects of capacity choices that should be made. The non-dedicated ICU design outperformed the dedicated ICU design in terms of efficient use of scarce resources.

conclusionsThe choice to use dedicated ICUs does not only affect the clinical outcome, but also rejection- rescheduling and occupancy rates. Our analysis of a large university hospital demonstrates how such a model can support decision making on ICU design, in conjunction with other operation characteristics such as staffing and quality management.

Indexed as

Intensive Care UnitsQuality ImprovementComputer SimulationDecision MakingDecision Making, OrganizationalHospitals, UniversityHumansLength of StayComputer SimulationCritical careHospital Bed CapacityOrganizational decision makingQuality of Healthcare

Identifiers

PMID38840245
PMCPMC11155026

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.