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INTENSIVE CARE UNIT AREAWIDE STUDY

Multnomah Foundation for Medical Care Portland, Oregon The increase of intensive care beds has been estimated at 4% per year. Almost every hospital with more than 200 beds now has an Intensive Care Unit (ICU)., Wagner et.al. report two factors for the increased demand of intensive care beds new surgical procedures requiring postoperative intensive care and the increased technical capabilities now available in most hospitals., In addition to treatment, attention has also been focused on monitoring or closely observing functions of ICUs., Study findings reported in national literature have indicated that a surprising percentage of patients admitted to intensive care units are stable and receive only observation or minimal amounts of active treatment.,-, This study attempts to assess the severity and level of services provided patients in intensive care units in Multnomah County, Portland, Oregon. Two criteria sets widely used in intensive care medicine were used to classify patients based on severity of illness and level of services provided. Seventeen physiologic measures weighted from 0-4 were used to reflect the severity of illness or ‘how sick‘ the patient was. See table 1 . These measures are part of the Acute Physiology and Chronic Health Evaluation (APACHE) classification system. This scoring system assumes that if a physiologic measurement is important in determining the severity of illness, it will be taken. Conversely, if a physiologic measurement is not important to the care of the patient it will either not be taken or the results will be normal., The sum of the assigned weights for all measurements recorded is the patient’s total physiology score. The higher the score, the more sick the patient. The Therapeutic Intervention Scoring System (TISS) was used to measure the consumption of ICU services by each patient. Each intervention is measured if provided at any time during the ICU stay. The TISS elements measured in this study are those active treatment interventions best provided in an ICU. See table 2. These criteria sets have been detailed in the literature.,