title: Changes after transformation from a specialized surgical unit to a general mixed intensive care unit.
abstract: OBJECTIVE
  We report the transition of a specialized surgical intensive care unit to a general mixed intensive care unit (ICU) and its influence on immediate outcome and performance data of the surgical population before and after the reorganization.
  
  
  METHODS
  All consecutive patients (2420 admissions) entering the surgical intensive care unit, period 2004-2007. After the year 2005, all specialized units were combined into 3 general mixed units.
  
  
  RESULTS
  Our population on the former surgical unit changed from mostly surgical patients to a mixed general ICU population, which comprises mostly of cardiac surgery patients. We saw better results in all overall outcome domains (ICU mortality, length of stay, and percentage of ICU readmissions). The ICU standardized mortality ratio remained the same. Surgical patients' outcome did not improve, nor did it decrease after the organizational change.
  
  
  CONCLUSIONS
  Organizational changes from a surgical ICU to a general mixed unit can have profound influences on performance data. Crude ICU outcome improved after the reorganization. Nevertheless, ICU standardized mortality ratio did not change.
authors.affiliation: Department of Surgery (Drs Timmers and Leenen) and Intensive Care Department (Dr Joore), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Tim K
authors.initials: TK
authors.lastname: Timmers
authors.forename: Hans C A
authors.initials: HC
authors.lastname: Joore
authors.forename: Luke P H
authors.initials: LP
authors.lastname: Leenen
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009936:Organizational Innovation; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D016012:Poisson Distribution; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome