Study: Busier ICUs discharge patients more efficiently

Busy intensive care units (ICUs) discharge patients at a faster rate at no detriment to patient outcomes, according to a new study published in the Annals of Internal Medicine.

Researchers at Penn Medicine analyzed more than 200,000 patients in 155 ICUs nationwide between 2001 and 2008. They found that during their busiest periods, ICUs discharged patients an estimated 6.3 hours earlier than they normally would. Furthermore, these patients experienced no increase in their odds of dying in the hospital or the overall length of their hospital stay, and no decrease in their odds of eventually going home.

The results indicate that rather than encouraging the rationing of care, bed availability pressure in ICUs may help promote more efficient discharge policies, according to lead researcher Jason Wagner, M.D., a senior fellow in the division of pulmonary, allergy and critical care at the Perelman School of Medicine at the University of Pennsylvania.

"We found that patients are discharged earlier but are no worse off--which suggests that in a strained-resource setting, doctors are more efficiently discharging patients into the appropriate next step of care," Wagner told Penn Medicine's news office. "This rightfully frees up critical care providers and beds for any potential incoming patients."

Improvement of ICUs--and how to measure their quality in the first place--has long been a concern for healthcare providers. A 2012 study from Johns Hopkins University found that more than a quarter of ICU patients had at least one missed diagnosis at the time they died. Although not all missed diagnoses necessarily caused the patient's death, researchers said they could very well lead to extended stays and poorer quality of life.

Another study from last May, however, indicated that performance metrics for ICU mortality rates may be unfairly weighed against larger hospitals because of "discharge bias," FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the Penn Medicine announcement