Intensive Care Medicine

, Volume 27, Issue 5, pp 865–872

The impact of organisational change on outcome in an intensive care unit in the United Kingdom

  • Graham Baldock
  • Peter Foley
  • Stephen Brett
Original

DOI: 10.1007/s001340100938

Cite this article as:
Baldock, G., Foley, P. & Brett, S. Intensive Care Med (2001) 27: 865. doi:10.1007/s001340100938

Abstract

Objectives: To study the change in outcome for patients admitted to an intensive care unit following the establishment of a team of resident medical staff and a change from an "open" to a "closed" organisational format. Design: Database review of prospectively collected data. Setting: Intensive care unit of a postgraduate teaching hospital. Subjects: 1134 admissions to the intensive care unit over a 3-year period, of whom 476 (42%) followed elective surgery. Main outcome measure: Hospital mortality corrected for illness severity by using the APACHE II scoring system. Results: Crude hospital mortality fell from 28% before the changes to 20% afterwards (P=0.01). With correction for case-mix factors, the probability of death after the changes was reduced by almost half (OR 0.51; CI 0.32, 0.82, P=0.005). Conclusion: A "closed" format of organisation of the delivery of care may result in improved outcomes for patients admitted to intensive care units.

Intensive care unit Staffing Organisation Outcome 

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Graham Baldock
    • 1
  • Peter Foley
    • 1
  • Stephen Brett
    • 1
  1. 1.Department of Anaesthesia and Intensive Care, Hammersmith Hospital, Du Cane Road, London W12 0HS, UKUK

Personalised recommendations