Critical Illness Clinical Trial
Official title:
The Association of ICU Organization and Structure on in Patient Mortality
We will test whether the way that an intensive care unit is organized can influence patient related outcomes such as mortality. We will test whether who works in the ICU, and how the ICU is managed will affect the care received by patients. The primary study hypothesis is whether the number of clinical protocols present in an intensive care unit is linked to patient mortality
Title: Do ICU Structural and Procedural Factors Influence Patient Related Outcomes: The
Critical Illness Outcome Study (CIOS)
Objectives: This is an exploratory ecologic study designed to examine the organizational and
structural factors present in adult intensive care units in the United States. A second
objective is to determine whether these organizational and structural factors are associated
with patient related outcomes. In addition, we intend to examine whether these
organizational and structural issues are associated with patient treatments.
Hypotheses: (Ho) A. The number of protocols used in an ICU is inversely associated with ICU
and hospital survival for critically ill patients.
B. Compliance with disease specific protocols is not independently associated with hospital
survival for critically ill patients
Specific Aims
1. To describe the organizational structure of participating intensive care units
2. To determine whether the number of protocols used in an intensive care unit is
associated with ICU and hospital survival for critically ill patients
3. To determine the frequency with which ICU's follow disease specific protocols for
patients with sepsis and ALI
Study Design
1. Prospective ecologic study of 50-60 adult intensive care units and admitted patients
2. ICU organizational and structural data will be collected for each participating ICU
3. 125-200 adult patients in each intensive care unit will be enrolled. Patients within
the ICU on a varying, specific day each week will be included. Demographic and
treatment variables will be collected for that day on that patient. Outcome data will
be collected on ICU and hospital discharge.
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Observational Model: Ecologic or Community, Time Perspective: Prospective
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