Policy Proposals for Mitigating ICU Strain: Insights from the COVID-19 Pandemic.

Publication date: Sep 05, 2024

ICU strain, characterized by a discrepancy between perceived or actual intensive care resources and demand, significantly impacts patient outcomes and healthcare worker well-being. The COVID-19 pandemic exacerbated ICU strain, leading to increased mortality and extended hospital stays, affecting both critically ill COVID-19 and non-COVID-19 patients. A systematic review identified 16 leading and lagging indicators of ICU capacity strain, including queuing, premature and after-hours ICU discharge, use of temporary space, length of stay, burnout, staffing and nurse-to-patient ratio, ICU census, acuity and turnover, standardized mortality ratio (SMR), readmissions, availability of critical supplies, ventilator use and surgery cancellation. However, variability in operational definitions and limited evidence regarding the reliability, validity, usability, and feasibility limit the value of single indicators for informed strategic planning and policy guidance. Regional and national policies and programs are essential to enhance real-time monitoring for effective management of critical care resources and mitigate the impact of ICU strain, facilitating complex interhospital transfers to reduce strain, and ensuring comprehensive strategies for enhancing ICU resilience. Proactive regional cooperation is advocated for policy formulation, knowledge exchange, and resource allocation to anticipate and mitigate ICU strain, ensuring equitable healthcare access during global health crises. The policy implications for future preparedness emphasize the importance of evidence-based triage and adaptable patient management strategies, alongside ethical considerations in resource allocation and the role of behavioral economic insights in optimizing resource utilization and collaborative healthcare practices. This multifaceted approach for addressing ICU strain comprehensively and effectively during pandemics would promote health equity and enhance healthcare system resilience under both routine operations and crisis conditions. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4. 0 (http://creativecommons. org/licenses/by-nc-nd/4. 0/).

Concepts Keywords
Creativecommons Care
Future Covid
Nurse Critical
Pandemics Healthcare
Surgery Icu
Indicators
Insights
Leading
Mortality
Non
Pandemic
Patient
Policy
Ratio
Strain

Semantics

Type Source Name
disease MESH COVID-19 Pandemic
disease MESH critically ill
disease MESH burnout
disease IDO role

Original Article

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