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Original article

Vol. 149 No. 3940 (2019)

Impact of staffing a surgical intermediate care unit with a critical care specialist

  • Géraldine Paratte
  • Tobias Zingg
  • Valérie Addor
  • Hélène Krief
  • Markus Schäfer
  • Nicolas Demartines
DOI
https://doi.org/10.4414/smw.2019.20117
Cite this as:
Swiss Med Wkly. 2019;149:w20117
Published
30.09.2019

Summary

AIM

To assess the impact of reorganising an 11-bed surgical intermediate care unit (IMCU) from an open to a semi-closed system in a Swiss University Hospital by adding a critical care specialist (CCS).

METHODS

This was a cohort study including adult IMCU patients enrolled in an Enhanced Recovery After Surgery protocol in the Department of Visceral Surgery, Lausanne University Hospital, from 1 February 2014 to 31 January 2016. Medical supervision by a CCS was implemented on 1 February 2015.

RESULTS

Introduction of a CCS in a surgical IMCU significantly reduced intensive care unit length of stay (p = 0.005) and potentially preventable operation (p = 0.04) for patients undergoing oesophageal surgery. A CCS in IMCU also proved to significantly reduce readmission in IMCU for hepatic surgery patients (p = 0.04). For other sub-specialties (colorectal, pancreatic and gastric bypass surgery) no significant difference could be found.

CONCLUSIONS

Reorganisation of a surgical IMCU from an open to a semi-closed system by implementing supervision by a CCS decreased length of stay and complications for the most fragile surgical patients (oesophageal and hepatic patients) after 12 months of implementation.

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