Surge Capacity: Analysis of Census Fluctuations to Estimate the Number of Intensive Care Unit Beds Needed. (15th July 2014)

• Record Type: Journal Article
• Authors: Olafson, Kendiss; Ramsey, Clare; Yogendran, Marina; Fransoo, Randall; Chrusch, Carla; Forget, Evelyn; Garland, Allan
• Is Part Of: Health services research. Volume 50:Number 1(2015:Feb.)
• Page Start: 237
• Page End: 252
• Publication Date: 2014-07-15
• Subjects: Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.12209
• Languages: English
• ISSNs: 0017-9124

Abstract

<abstract abstract-type="main" id="hesr12209-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hesr12209-sec-0001" sec-type="section"> <title>Objective</title> <p>To compare methods of characterizing intensive care unit (ICU) bed use and estimate the number of beds needed.</p> </sec> <sec id="hesr12209-sec-0002" sec-type="section"> <title>Study Setting</title> <p>Three geographic regions in the Canadian province of Manitoba.</p> </sec> <sec id="hesr12209-sec-0003" sec-type="section"> <title>Study Design</title> <p>Retrospective analysis of population‐based data from April 1, 2000, to March 31, 2007.</p> </sec> <sec id="hesr12209-sec-0004" sec-type="section"> <title>Methods</title> <p>We compared three methods to estimate ICU bed requirements. Method 1 analyzed yearly patient‐days. Methods 2 and 3 analyzed day‐to‐day fluctuations in patient census; these differed by whether each hospital needed to independently fulfill its own demand or this resource was shared across hospitals.</p> </sec> <sec id="hesr12209-sec-0005" sec-type="section"> <title>Principal Findings</title> <p>Three main findings were as follows: (1) estimates based on yearly average usage generally underestimated the number of beds needed compared to analysis of fluctuations in census, especially in the smaller regions where underestimation ranged 25–58 percent; (2) 4–29 percent fewer beds were needed if it was acceptable for demand to exceed supply 18 days/year, versus 4 days/year; and (3) 13–36 percent fewer beds were needed if hospitals within a region could effectively share ICU beds.</p> </sec> <sec id="hesr12209-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Compared to using yearly averages, analyzing day‐to‐day fluctuations in patient census gives a more accurate picture of ICU bed use. Failing to provide adequate "surge capacity" can lead to demand that frequently and severely exceeds supply.</p> </sec> </abstract>