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Ward capacity strain: A novel predictor of delays in intensive care unit survivor throughput

Annals of the American Thoracic Society March 1, 2019

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Healthcare capacity strain occurs when patients’ demand for clinical resources exceeds availability. In prior research of intensive care units (ICUs) and emergency departments (EDs), higher patient volume, turnover, and severity of illness have shown associations with patient outcomes (e.g., mortality), patient throughput, and care delivery. Less well understood are ward-based threats to survivors of critical illness. This gap in knowledge impacts the over 90% of ICU survivors who transition from ICUs to general hospital wards. We previously identified an association between ward patient volume, staff workload, and overall acuity with 30-day hospital readmissions in this population. However, metrics of strain on general hospital wards have not been clearly defined. As a next step to validate the construct of ward capacity strain, our objective was to identify measurable ward-level factors associated with ward admission wait times, because prior literature has demonstrated that increased ED wait times are associated with adverse patient outcomes among critically ill patients. Preliminary results of this work were previously presented as an abstract at the American Thoracic Society International Conference in 2017.


National Institutes of Health/National Heart, Lung, and Blood Institute