Relationship between ICU design and mortality.

Abstract:

BACKGROUND:Architectural design of health-care facilities can influence patient safety; however, it is unknown whether patient outcomes are significantly affected by ICU design. METHODS:Six hundred sixty-four patients admitted to the medical ICU (MICU) of Columbia University Medical Center during 2008 were included in this retrospective study. Patient outcome measures, which included hospital mortality, ICU mortality, ICU length of stay (LOS), and ventilator-free days, were compared based on random room assignment. Rooms that were not visible from the MICU central nursing station were designated as low-visible rooms (LVRs), whereas the remaining rooms were designated as high-visible rooms (HVRs). RESULTS:Overall hospital mortality did not differ among patients assigned to LVRs vs HVRs; however, severely ill patients (those with Acute Physiology and Chronic Health Evaluation II scores > 30) had significantly higher hospital mortality when admitted to an LVR than did similarly ill patients admitted to an HVR (82.1% and 64.0%, n = 39 and 75, respectively; P = .046). ICU mortality showed a similar pattern. ICU LOS and ventilator-free days did not differ significantly between groups. CONCLUSIONS:Severely ill patients may experience higher mortality rates when assigned to ICU rooms that are poorly visualized by nursing staff and physicians.

journal_name

Chest

journal_title

Chest

authors

Leaf DE,Homel P,Factor PH

doi

10.1378/chest.09-1458

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

1022-7

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(10)60225-5

journal_volume

137

pub_type

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