title: The impact of implementing critical care team on open general intensive care unit.
abstract: BACKGROUND
  There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes.
  
  
  METHODS
  We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation.
  
  
  RESULTS
  We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05).
  
  
  CONCLUSIONS
  Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.
authors.affiliation: Department of Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
authors.forename: Ick Hee
authors.initials: IH
authors.lastname: Kim
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Park
authors.forename: Seonguk
authors.initials: S
authors.lastname: Kim
authors.forename: Sang-Don
authors.initials: SD
authors.lastname: Han
authors.forename: Seung Seok
authors.initials: SS
authors.lastname: Ki
authors.forename: Gyu Rak
authors.initials: GR
authors.lastname: Chon