2014 – 2018. IDENTIFYING AND EVALUATING INTENSIVE CARE UNIT CAPACITY STRAIN IN ALBERTA.

Project Title: Identifying and Evaluating Intensive Care Unit Capacity Strain in Alberta.

Overview: The growing population of Alberta is projected to have a sustained increase in the demand for health services, especially in service areas with limited resources such as intensive care units (ICU’s). Currently, ICUs in Alberta routinely operate at or near full capacity and only have marginal reserve to accommodate the next critically ill patient. Many ICUs in Alberta are regularly unable to admit sick patients for many hours a day. Accordingly, the demand for access to ICU services is high; however the supply remains limited. This mismatch in supply and demand creates enormous”strain” on our health care system. This strain on ICU capacity contributes to a decrease in quality of care and elevated risk for poor outcomes for patients in need of ICU services.

The overarching goal of this research project is to identify, measure, and validate performance measures of ICU capacity strain across all Alberta ICUs and establish a provincial framework to model and develop novel evidence-informed process management changes to improve ICU access and throughput and reduce ICU capacity strain.

Primary Investigator: Dr. Sean Bagshaw

Research Associates: Dawn Opgenorth - Project Manager

Patient and Family Advisors: N/A

Award: $743,808.00

Funding Body: Partnership for Research and Innovation in the Health System from Alberta Innovates – Health Solutions

Citations: 

Bagshaw SM, Wang X, Zygun DA, Dodek P, Garland, A, Scales DC, Berthiaume L, Faris P, Chen G, Opgenorth D, Stelfox HT. Association between strained capacity and mortality among patients admitted to intensive care: A path-analysis modeling strategy. Journal of Critical Care, [24 Aug 2017, 43:81-87] DOI: 10.1016/j.jcrc.2017.08.032

Azevedo LC, de Souza IA, Zygun DA, Stelfox HT, Bashaw SM. Association between nighttime discharge from the intensive care unit and hospital mortality: A multi-center retrospective cohort study. BMC Health Services Research [14 Sep 2015, 15:378] DOI: 10.1186/s12913-015-1044-4

Bagshaw SM, Opgenorth D, Potestio M, Hastings SE, Hepp SL, Gilfoyle E, McKinlay D, Boucher P, Meier M, Parsons-Leigh J, Gibney RT, Zygun DA, Stelfox HT. Healthcare provider perceptions of causes and consequences of ICU Capacity Strain in a large publicly funded integrated health region: A qualitative study. Critical Care Medicine [15 Sep 2016, 45(4):e347-e356] DOI: 10.1097/CCM.0000000000002093

Sotani SA, Ingolfsson A, Zygun DA, Stelfox HT, Hartling L, Featherstone L, Opgenorth D, Bagshaw SM. Quality and performance measures of strain on intensive care capacity: a protocol for a systematic review. Systematic Reviews [12 Nov 2015, 4:158] DOI 10.1186/s13643-015-0145-9

Abstracts

D Opgenorth, HT Stelfox, M Potestio, P Wickson, DA Zygun, E Gilfoyle, N Gibney, M Meier, P Boucher, D McKinlay, SM Bagshaw. Sources of Impact of Strain on Intensive Care Unit Capacity: A Survey of Critical Care Professionals. Critical Care Canada Forum, Toronto, Ontario, 2015

SM Bagshaw, D Opgenorth, P Wickson, DA Zygun, E Gilfoyle, N Gibney, M Meier, P Boucher, D McKinlay, M Potestio, HT Stelfox. Physician Perceptions of Sources of Impact of Strain on Intensive Care Unit Capacity: A Qualitative Study. Critical Care Canada Forum, Toronto, Ontario, 2015

D Opgenorth, HT Stelfox, M Potestio et al. Healthcare Provider Perceptions of Sources and Impact of Strain on ICU Capacity: A Qualitative Study. Critical Care Canada Forum, Toronto, Ontario, 2015

Adam Hall, H. Thomas Stelfox, Xioaming Wang, Guanmin Chen, Dan Zuege, Peter Dodek, Allan Garland, Damon Scales, Luc Berthiaume, David A. Zygun, Sean M. Bagshaw. Association between after-hours admission and discharge from the intensive care unit and mortality. Critical Care Canada Forum, Toronto, Ontario, 2017