TY  - JOUR
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Anesthesiology
KW  -  critical care
KW  -  health services research
KW  -  patient safety
KW  -  perioperative care
KW  -  postoperative complications
KW  -  SURGERY
KW  -  MORTALITY
KW  -  SURVIVAL
TI  - Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand
SP  - 460
UR  - https://doi.org/10.1016/j.bja.2018.12.026
VL  - 122
N2  - Background
Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional ?high-acuity? beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods
We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital- and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities.

Results
We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals reported fewer critical care beds per 100 hospital beds (median=2.7) compared with Australia (median=3.7) and NZ (median=3.5). Additionally, 31.1% of hospitals reported having high-acuity beds to which high-risk patients were admitted for postoperative management, in addition to standard ICU/HDU facilities. The estimated numbers of critical care beds per 100 000 population were 9.3, 14.1, and 9.1 in the UK, Australia, and NZ, respectively. The estimated per capita high-acuity bed capacities per 100 000 population were 1.2, 3.8, and 6.4 in the UK, Australia, and NZ, respectively.

Conclusions
Postoperative critical care resources differ in the UK, Australia, and NZ. High-acuity beds may have developed to augment the capacity to deliver postoperative critical care.
AV  - public
JF  - British Journal of Anaesthesia
EP  - 469
SN  - 1471-6771
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
ID  - discovery10074818
Y1  - 2019/04//
PB  - ELSEVIER SCI LTD
A1  - Wong, DJN
A1  - Popham, S
A1  - Wilson, AM
A1  - Barneto, LM
A1  - Lindsay, HA
A1  - Farmer, L
A1  - Saunders, D
A1  - Wallace, S
A1  - Campbell, D
A1  - Myles, PS
A1  - Harris, SK
A1  - Moonesinghe, SR
IS  - 4
ER  -