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The COVID-19 health crisis has highlighted pre-existing challenges in patient flow management within healthcare facilities, especially in critical care units. This has sparked debate regarding the sufficiency of critical care beds in France, while drawing attention to the lack of downstream structures. Inefficient patient flow, leading to bed occupancy bottlenecks, has been correlated with both critical care length of stay and morbidity. Unplanned early readmission to critical care further exacerbates these strains and prolongs hospital length of stay. Currently, no standardized criteria are available to guide safe discharge from critical care. A recent Delphi consensus study proposed a set of criteria, although largely subjective. The primary outcome of the present study is to identify factors associated with unplanned early readmission to critical care within 48 hours of discharge. Delayed discharge from critical care represents another major bottleneck contributing to system strain. The secondary outcome of this study is therefore to assess the proportion of critical care beds occupied by patients deemed ready for discharge by the medical team, as well as to analyze the reasons underlying such delayed transfers.
The COVID-19 health crisis has highlighted pre-existing challenges in patient flow management within healthcare facilities, especially in critical care units. This has sparked debate regarding the sufficiency of critical care beds in France, while drawing attention to the lack of downstream structures. Inefficient patient flow, leading to bed occupancy bottlenecks, has been correlated with both critical care length of stay and morbidity. Unplanned early readmission to critical care further exacerbates these strains and prolongs hospital length of stay. Currently, no standardized criteria are available to guide safe discharge from critical care. A recent Delphi consensus study proposed a set of criteria, although largely subjective. The primary outcome of the present study is to identify factors associated with unplanned early readmission to critical care within 48 hours of discharge. Delayed discharge from critical care represents another major bottleneck contributing to system strain. The secondary outcome of this study is therefore to assess the proportion of critical care beds occupied by patients deemed ready for discharge by the medical team, as well as to analyze the reasons underlying such delayed transfers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No intervention /Observation | No intervention: observation of patients with early eeadmission to the ICU |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | Only observation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Early Readmission to the ICU | Patients readmitted to the ICU less than 48 hours after their first discharge | From the first day of recruitment to 48 hours after the end of recruitment |
| Measure | Description | Time Frame |
|---|---|---|
| Readmission to the ICU | Patients readmitted to the ICU less than 30 days after their first discharge | From the first day of admission to 30 days of follow up |
| 30-days mortality | Patients dead by day 30 of the follow-up |
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Inclusion Criteria:
Exclusion Criteria:
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All patients aged 18 years or older admitted to the ICU
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Merlin DELOURME,, MD | Contact | +33 1 42 49 93 94 | merlin.delourme@aphp.fr | |
| François DEPRET | Contact | +33 1 42 49 93 94 | francois.depret@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| François DEPRET | Hôpital Saint-Louis, AP-HP | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Saint-Louis, AP-HP | Recruiting | Paris | 75010 | France |
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| From the first day of admission to 30 days of follow up |
| Rate of bed occupancy by patients deemed fit for discharged | Patients still hospitalized in the ICU the day after they were deemed fit for discharge by the medical team | From the first day of the study to the 7th day of the study |