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The intensive care unit (ICU) in a hospital caters for critically ill patients. The number of the ICU beds has a direct impact on many aspects of hospital performance. Lack of the ICU beds may cause ambulance diversion and surgery cancellation, while an excess of ICU beds may cause a waste of resources. This paper aims to develop a discrete event simulation (DES) model to help the healthcare service providers determine the proper ICU bed capacity which strikes the balance between service level and cost effectiveness.

The DES model is developed to reflect the complex patient flow of the ICU system. Actual operational data, including emergency arrivals, elective arrivals and length of stay, are directly fed into the DES model to capture the variations in the system. The DES model is validated by open box test and black box test. The validated model is used to test two what‐if scenarios which the healthcare service providers are interested in: the proper number of the ICU beds in service to meet the target rejection rate and the extra ICU beds in service needed to meet the demand growth.

A 12‐month period of actual operational data was collected from an ICU department with 13 ICU beds in service. Comparison between the simulation results and the actual situation shows that the DES model accurately captures the variations in the system, and the DES model is flexible to simulate various what‐if scenarios.

DES helps the healthcare service providers describe the current situation, and simulate the what‐if scenarios for future planning.

Public Works and Government Services Canada (PWGSC) is the federal department responsible for housing over 190,000 Canadian federal public servants. During Y2K preparations, it became apparent that a single source or form of integrated, emergency response information at the infrastructure level did not exist. A process had to be created and developed that would serve as a single vehicle and source for building‐based emergency response. These preparations for Y2K saw the creation of the Infrastructure Continuity Unit (ICU) and a system for the creation, validation, and maintenance of Infrastructure Continuity Plans (ICPs). An ICP is an event‐management document that contains a series of procedures and protocols to be used during a building‐based incident or disruption of services. The ICU is supported nationally by a network of Regional Coordinators who oversee the gathering of information needed to create ICPs for their own parts of the country. This paper demonstrates how this system, along with the ICU’s recent certification by the Canadian General Standards Board (CGSB) to the ISO 9000 standard, have contributed to the ICU’s success. This paper takes the reader through an in‐depth exploration of the ICU’s processes, methodologies and procedures and demonstrates why, in a post‐September 11th world, the ICU has begun to attract international attention.

The purpose of this paper is to examine nurses’ attitudes towards safety culture in six Saudi Arabian intensive care units (ICUs).

The study is descriptive with a cross-sectional design. The Safety Attitude Questionnaire (SAQ)-ICU version was distributed and 216 completed questionnaires were returned.

The findings provide a basis for further research on Saudi Arabian ICU safety culture. This study showed that the SAQ-ICU can be used to measure safety climate to identify areas for improvement according to nurse attitudes and perceptions. Findings indicate that ICU safety culture is an important issue that hospital managers should prioritise.

The SAQ-ICU questionnaire, used to measure safety climate in Saudi Arabian ICUs, identifies service strengths and improvement areas according to attitudes and perceptions.

To the knowledge, this is the first study to use SAQ to examine nurses’ safety culture attitudes in Saudi Arabian ICUs. The present findings provide a baseline and further details about Saudi Arabian ICU safety. Study participants represented nine nationalities, indicating the nursing workforce's diversity, which is expected to continue in the future. Such a nursing cultural heterogeneity calls for further studies to examine and evaluate attitudes and values to improve ICU safety culture.

Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward.

The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden.

A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU.

The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.

The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.

The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.

No studies have examined preoperative handoffs from the intensive care unit (ICU) to OR. Given the risk of patient harm, the authors developed a standardized ICU to OR handoff using a previously published handoff model. The purpose of this paper is to determine whether a standardized ICU to OR handoff process would increase the number of team handoffs and improve patient transport readiness.

The intervention consisted of designing a multidisciplinary, face-to-face handoff between sending ICU providers and receiving anesthesiologist and OR nurse, verbally presented in the I-PASS format. Anticipatory calls from the OR nurse to the ICU nurse were made to prepare the patient for transport. Data collected included frequency of handoff, patient transport readiness, turnover time between OR cases, and anesthesia provider satisfaction.

In total, 57 audits were completed. The frequency of handoffs increased from 25 to 86 percent (p<0.0001) and the frequency of patient readiness increased from 61 to 97 percent (p=0.001). There were no changes in timeliness of first start cases and no significant change in turnover times between cases. Anesthesia provider satisfaction scores increased significantly.

A standardized, team based ICU to OR handoff increased the frequency of face-to-face handoffs, patient readiness and anesthesia provider satisfaction within increasing turnover between cases.

Although studies have identified the transition of patients from the ICU to the OR as a period of increased harm, the development of a preoperative ICU to OR handoff had not been described. This intervention may be used in other institutions to design ICU to OR transitions of care.

The purpose of this literature review was to explore to what extent quality management (QM) and nursing science offer complementary perspectives to provide better quality care, by looking at QM core concepts and tools.

A systematic literature review was conducted. Papers published in academic journals between January 2013 and December 2019 were included. A deductive content analysis was chosen using QM core values as an analytical framework.

The results showed that QM core values, methodologies and tools were found in the reviewed articles about intensive care unit (ICU) transitional care. The results indicated that core values in QM and the core competencies within nursing science in ICU transitional care are mutually dependent upon each other and exist as a whole. ICU transitional care is, however, a complex interpersonal process, characterized by differences in organizational cultures and core values and involving multidisciplinary teams that collaborate across hospital units. The QM core value that was least observed was committed leadership.

Combining QM and nursing science can contribute to a deeper understanding of how to improve the ICU transitional care process by bringing complementary perspectives.

The included articles portray how QM is applied in ICU transitional care. Implications for future research focus on enhancing the understanding of how QM and nursing science can bring complementary perspectives in order to improve ICU transitional care and how QM values, methodologies and tools can be used in ICU transitional care. Committed leadership and team collaboration in ICU transitional care are areas that call for further research.

The findings contribute to the body of literature by providing important insights in terms of how QM core values, methodologies and tools are present in research about ICU transitional care and how the two research subjects, namely, QM and nursing science, bring complementary perspectives.

Team collaboration is essential to ensure the quality of care and patient safety when critically ill patients are transferred from an intensive care unit (ICU) to a general ward. Measuring team collaboration in the patient transfer process can help gain insights into how team collaboration is perceived and how it can be improved. The purpose of this paper is to describe the development and testing of a questionnaire aiming to measure perceived team collaboration in the patient transfer process from ICU to the general ward. This study also aims to analyze the results to see how the survey could help improve team collaboration within ICU transitional care.

Statements, factors and main areas intended to measure perceived team collaboration were developed from a theory. The questionnaire was tested in two ICUs at two hospitals located in Sweden, and the results were analyzed statistically.

The results showed that the questionnaire could be used for measuring perceived team collaboration in this process. The results from the survey gave insights that can be useful when improving team collaboration in ICU transitional care.

The collaboration between two research subjects, Nursing Science and Quality Management, has given new perspectives in how cultural and systemic differences and opportunities can help improving team collaboration in ICU transitional care, by shifting focus from the individual to team, culture, system, process and continuous improvement.

The developed questionnaire can be used to measure perceived team collaboration and to identify areas for improving team collaboration in the ICU transitional care process.

There is a sparse amount of research about measuring team collaboration in ICU transitional care, and this study contributes to filling this research gap.

This study aimed to compare mortality rate, length of stay (LOS) and hospitalization costs at different priority levels for a patient admitted to an intensive care unit (ICU) at a public tertiary hospital in Qazvin, Iran. This study also aimed to predict influencing factors on patients’ mortality, ICU LOS and hospitalization costs in different admission groups.

The authors conducted a retrospective cohort study among patients who mainly suffered from internal diseases admitted to an ICU of a public hospital. This study was conducted among 127 patients admitted to ICU from July to September 2019. The authors categorized patients into four groups based on two crucial hemodynamic and respiratory status criteria. The authors used a logistic regression model to predict the likelihood of mortality in ICU admitted patients during hospitalizations for the four prioritization groups. Furthermore, the authors conducted a multivariate analysis using the “enter” method to identify risk factors for LOS.

Results showed a statistically significant relationship between the priority of being admitted to ICU and hospitalization costs. The authors’ findings revealed that age, LOS and levels of consciousness had a predictability role in determining in-hospital mortality. Besides, age, gender, consciousness level of patients and type of the disease were mentioned as affecting factors of LOS.

This study’s findings emphasize the necessity of categorizing patients according to specific criteria to efficiently use available resources to help health-care authorities reduce the costs and allocate the budget to different health sectors.

This qualitative phenomenological study examined the experiences of patients, their family members, and the nurses in the intensive care unit during critical illness. Five participants from each category participated in two interviews over a period of five months. Content analysis of the interview transcripts revealed five integrating common themes, each reflecting concepts from the Roy Adaptation Model (RAM). The ICU experience among all participants is interdependence. Adaptation in the ICU integrated family as a unit, physical care/comfort, physiological care and psychosocial support, resulting in transformation.

The study aims to determine the factor of perceived machine learning adoption (MLA) values that affect learners' intention to continue using (ICU), the extent of their relationships in the learners' ICU and the role of locus of control (LOC) in their relationship.

The study employed a rigorous literature review of MLA studies that lead to a multidimensional value-based theoretical model. This model combined the theory of consumption and altruistic values. Simple descriptive statistics provide the frequency and percentage of the demographic profile. An orthogonalized approach was used to assess for investigating moderating effects. The data and model analysis used a convenience sample of 419 undergraduate perceptions of MLA value from rural higher education institutions (HEIs) in the Philippines.

The findings indicate that three perceived values (functional value (FUV), social value (SOV) and spiritual value (SPV)) of MLA significantly affect learners' ICU. Interestingly, the study found that LOC strengthens the positive relationship of FUV on learners' ICU.

The study is one of the few to provide evidence on using a multidimensional value-based adoption model in MLA. The study successfully integrates SPV to the concept of perceived value ignored in the theory of consumption value (TCV) and the role of LOC on FUV relationship to learners' ICU.