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Characterization of Strained Wards and the Impact...

Characterization of Strained Wards and the Impact on Patient Outcomes and Intensive Care Unit Admission and Discharge


In operations terms, capacity strain can be defined as "limited capacity and the resulting problems of waiting times and throughput losses." Strain may be caused by anything that results in a demand for resources in excess of those that are available. The PAIR Center team has studied capacity strain in the ICU setting extensively. We have shown that several factors contribute to the strain perceived by frontline clinicians in the ICU, including not only the number of patients, but also their severity of illness, the number of new admissions to the ICU, and even factors external to the ICU, such as the capacity of general wards. It is still unknown which factors contribute to capacity strain within general medical wards and how such “ward strain” influences both triage decisions for patients on the margins of intensive care unit (ICU) discharge and these patients’ subsequent outcomes. Improved understanding of ward capacity strain therefore holds great potential for improving patient outcomes and hospital ICU-to-ward transitions. Our prior work not only identified measures of ICU capacity strain but also explored their role in patient outcomes and in ICU discharge practices. Using a similar approach and data from the University of Pennsylvania Health System from 2012-2015, we aim to identify factors that cause capacity strain on medical wards, as well as test the association of ward capacity strain on processes of care and outcomes of ICU survivors.


  • National Heart, Lung, and Blood Institute

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