Akademik Veri Yönetim Sistemi
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, cilt.1, sa.1, ss.1, 2025 (SCI-Expanded)
Background: It is well known that intensivist in the intensive care unit(ICU) is
critical for optimal patient care. However, today the majority of surgical
intensive care units(SICUs) provide service in an open-model. Our aim was to
assess the effects of appointing an intensivist to the Surgical Intensive Care
Unit (SICU) and transitioning to a semi-open working model on patient outcomes
and various quality indicators.
Methods: This retrospective study was conducted in a seven-bed SICU of a university
hospital. Two groups were created from patients treated before (pre-intensivist
period) and after (post-intensivist period) the change of ICU management. Demographic data of the
patients, disease severity scores, surgical interventions performed, and
intensive care quality indicators were collected and statistically compared
between the two periods. Reporting of this study complied with the
"Revised Standards for Quality Improvement Reporting Excellence(SQUIRE
2.0)" standards.
Results: With
the introduction of an intensive care specialist during working hours and the
adoption of a semi-open working model, the following improvements were
observed: the average length of stay decreased from 11 days vs 5 days, the
average duration of mechanical ventilation reduced from 5.6 days vs 1 day, and
the rate of mechanical ventilation use decreased from 48% vs 21%. A significant
reduction in the need for tracheostomy was also noted (p<0.001) . Furthermore, the bed turnover rate
increased from 20 vs 24, enhancing bed utilization efficiency. Additionally,
the observed mortality rate of 15% was lower than the expected rate of 25%,
resulting in a significant reduction in the Standardized Mortality Ratio (from 1.05 vs 0.6).
Conclusion:
This study proves that
surgeon-intensivist collaboration and a semi-open model in intensive care units
play a critical role by reducing mortality, increasing resource utilisation
efficiency and improving patient outcomes. Our findings emphasise the need to
restructure SICU processes with a multidisciplinary approach.