Challenging Organizational Factors Associated With Admission Delay to the Intensive Care Unit – a Novel Quality Indicator

Abstract

Abstract Background: Delays in admitting patients to the ICU can defer the timely initiation of life-sustaining therapies and invasive monitoring, jeopardizing the success of the treatment. The current study aimed to assess the factors related to delays in admission times of critically ill patients transferred to the ICU using a proactive approach to admission process analysis.Methods: A specifically designed software was created to follow up, compare and measure the defined laps of the time to admission, implemented at the ICU for six months. Measurements included five time-lapse, referral department, and work shift at admission. Data of 1004 patients admitted to the ICU between July 2017 to January 2020 were analyzed in a retrospective observational study.Results: A significant shortening of time to admission before and after the intervention done by the institutional Quality Control Commission. The mean time to admission was shortened by 14 minutes, from a mean of 92.4 minutes to 78.6 minutes. Insights about the organizational factors delaying transfer provide meaningful information for future efficacy interventions. Conclusions: The current study shows the positive effect of a protracted follow-up of the complex process divided into several stations, where possible preventable situations can be found and modified. Trial registration: The study was approved by the Ashkelon Academic College Ethics Committee (Approval # 25/1-2020).