According to Yusuf (2010) “One of the debates that hospitals engage in is whether to have an open or closed ICU. The facility at which I currently practice has been having ongoing discussions with regard to this very issue. We have a very good intensive care unit for a moderate sized community Hospital of 200 beds. Up to about 2 years ago we had an open intensive care unit. We also had a large amount of primary care physicians admitting to the hospital and the intensive care unit We were fortunate to have pulmonologist and intensive who provided coverage to the intensive care unit on a regular basis via consultations and direction of care to any physician so requesting. In the last year a director of the intensive care was hired and per his
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The intensivist as well as nursing staff are trained in the specific care of these patients. In smaller hospitals there are usually one or two intensive care units or cardiac care unit, which require intensivist to be much more versed in the treatment of various types of patients. As in our institution many intensivist are not in tune with the specific needs and care of some sub specialty groups. This is often the case with surgical patients. These patients are managed completely different in the postoperative than most other ICU patients. For this reason even hospitals such as ours who have closed units still allow surgeons to admit and manage their patients apart or in conjunction with intensivist. Larger hospitals will often have separate medical and surgical ICU’s. One of the largest advantages of closed units are a more close management of patients in the ICU, patients are often given more direct and constant care, as the intensivist are readily available to address nursing concerns or any acute changes in the patient's condition. Intensivist also have much more time and availability to discuss the patient's care with the families do to lower patient volume. This is often very important as end-of-life decisions and concerns about into advanced monitoring and treatments often need to be discussed with families who have not addressed these in the past. From the value-based standpoint one of the biggest advantage of a close intensive care unit is the financial impact. By having the intensivist involved, the care of the patient is streamlined and the time spent the intensive care unit is significantly decreased. As the cost of the intensive care is quite significant, by decreasing length of stay in the ICU hospitals are able to realize improve revenue streams. Often when patients are admitted to an open ICU length of stays decrease
The intensivist as well as nursing staff are trained in the specific care of these patients. In smaller hospitals there are usually one or two intensive care units or cardiac care unit, which require intensivist to be much more versed in the treatment of various types of patients. As in our institution many intensivist are not in tune with the specific needs and care of some sub specialty groups. This is often the case with surgical patients. These patients are managed completely different in the postoperative than most other ICU patients. For this reason even hospitals such as ours who have closed units still allow surgeons to admit and manage their patients apart or in conjunction with intensivist. Larger hospitals will often have separate medical and surgical ICU’s. One of the largest advantages of closed units are a more close management of patients in the ICU, patients are often given more direct and constant care, as the intensivist are readily available to address nursing concerns or any acute changes in the patient's condition. Intensivist also have much more time and availability to discuss the patient's care with the families do to lower patient volume. This is often very important as end-of-life decisions and concerns about into advanced monitoring and treatments often need to be discussed with families who have not addressed these in the past. From the value-based standpoint one of the biggest advantage of a close intensive care unit is the financial impact. By having the intensivist involved, the care of the patient is streamlined and the time spent the intensive care unit is significantly decreased. As the cost of the intensive care is quite significant, by decreasing length of stay in the ICU hospitals are able to realize improve revenue streams. Often when patients are admitted to an open ICU length of stays decrease