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  • Open Access

Impact of increased numbers of intensive care consultants on outcome in a central London teaching hospital

  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care201115 (Suppl 1) :P473

https://doi.org/10.1186/cc9893

  • Published:

Keywords

  • Support System
  • Surrogate Marker
  • Standardise Mortality Ratio
  • Closed Model
  • Care Consultant

Introduction

The standardised mortality ratio (SMR) is a key parameter by which ICUs quantify their performance. We report the effect of increased ICU consultant numbers on mortality and SMR in a central London teaching hospital.

Methods

The study was registered with the Clinical Audit Support System. Data were collected prospectively from March 2005 to date by a dedicated audit team and were analysed as part of routine audit.

Results

Table 1 shows the reduction in mortality and SMR from 2005 to date, comparing these data with patient and consultant numbers.
Table 1

SMR and mortality reduction from 2005 to date

 

Number of admissions

Number of consultants

Median APACHE II

ICU mortality (%)

ICU SMR

2005 to 2006

646

5

18

34.4

0.93

2006 to 2007

774

5

17

19.3

1.15

2007 to 2008

842

9

14

16.8

0.91

2008 to 2009

1,510

13

14.5

14.7

0.77

2009 to 2010

1,671

13

17

19.3

0.67

2010 to 2011

(incomplete)

1,434

17

19

19

0.62

Conclusions

In this study we describe the remarkable reduction in both mortality and SMR that has occurred in the general ICU at King's College Hospital over the past 5 years. The improvement in outcomes was associated with a quadrupling of ICU consultant numbers. We hypothesize that this increase in intensivist numbers allowed the reinforcement of a closed model of ICU care. We are now further analysing these data to search for quantitative improvements in surrogate markers of quality of care over the same time frame.

Authors’ Affiliations

(1)
King's College Hospital, London, UK

References

  1. Provonost PJ, et al.: JAMA. 2002, 288: 2151-2162. 10.1001/jama.288.17.2151View ArticleGoogle Scholar
  2. Baldock G, et al.: Intensive Care Med. 2001, 27: 865-872. 10.1007/s001340100938View ArticlePubMedGoogle Scholar

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