Intensive care unit design and mortality in trauma patients

Abstract Background The architecture of medical care facilities ca affect the safety of a patient, but it is unknown if the architecture affects outcomes. We hypothesized that patients in rooms who are more visible from the central nursing station would experience better outcomes than those patients...

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Bibliographic Details
Published in:The Journal of surgical research 2014-08, Vol.190 (2), p.640-646
Main Authors: Pettit, Nicholas R., PhD, Wood, Teresa, PhD, Lieber, Mike, MS, O'Mara, Michael S., MD, MBA, FACS
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Hospital Mortality
Humans
ICU
ICU design
Intensive care unit
Intensive Care Units - statistics & numerical data
Length of Stay
Male
Middle Aged
Mortality
Nursing Stations
Ohio - epidemiology
Retrospective Studies
Surgery
Trauma
Wounds and Injuries - complications
Wounds and Injuries - mortality
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Summary:Abstract Background The architecture of medical care facilities ca affect the safety of a patient, but it is unknown if the architecture affects outcomes. We hypothesized that patients in rooms who are more visible from the central nursing station would experience better outcomes than those patients in less visible rooms. Materials and methods A total of 773 patients admitted to the trauma intensive care service over a 12-mo period were retrospectively evaluated. Outcomes were hospital mortality and intensive care unit (ICU) length of stay (LOS). The unit is designed with a bank of high-visibility rooms (HVRs) directly across from the nursing station and two side sections of low-visibility rooms (LVRs). No formal triage occurs, but patients are prioritized to HVRs as available. Results Patients in the HVRs had a 16% mortality (52 of 320); meanwhile, the patients in the LVRs experienced an 11% mortality (49 of 448, P  = 0.03). ICU mortality did not differ significantly when controlling for age, Charlson Comorbidity Index (CCI), Head Abbreviated Injury Score, and the Injury Severity Score (ISS) ( P  = 0.076). Age, CCI, Head Abbreviated Injury Score, and ISS did individually correlate with mortality (age: P  = 0.0008; CCI: P  = 0.017; and ISS: P  
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2014.04.007