Relationship between ICU design and mortality.
Chest. 2010 Jan 15;
Authors: Leaf DE, Homel P, Factor PH
BACKGROUND: Architectural design of healthcare facilities can influence patient safety, however, it is unknown whether patient outcomes are significantly affected by intensive care unit (ICU) design. METHODS: 664 patients admitted to the medical intensive care unit (MICU) of Columbia University Medical Center during 2008 were included in this retrospective study. Patient outcome measures, which included hospital mortality, ICU mortality, ICU length of stay, and ventilator-free days, were compared based on random room assignment. Patients assigned to rooms which were not visible from the MICU central nursing station were designated as low visible rooms (LVRs), while the remaining rooms were designated as high visible rooms (HVRs). RESULTS: Overall hospital mortality did not differ among patients assigned to LVRs versus HVRs, however, severely ill patients (those with APACHE II scores greater than 30) had significantly higher hospital mortality when admitted to a LVR than similarly ill patients admitted to a HVR (82.1 and 64.0%, N=39 and 75, respectively; p=0.046). ICU mortality showed a similar pattern. ICU length of stay and ventilator-free days did not differ significantly between groups. CONCLUSIONS: Severely ill patients may experience higher mortality rates when assigned to ICU rooms that are poorly visualized by nursing staff and physicians.
PMID: 20081100 [PubMed - as supplied by publisher]