Chicago's Lurie Children's Hospital is opening a 20-bed ward for patients who are too sick for general inpatient care but don't need an intensive-care unit.
The intermediate-care unit is set to open Feb. 22 at the Streeterville, Ill., hospital. It will have a staff of about 75, and the average length of stay for patients will be 36 to 72 hours, compared with 24 to 36 hours in Lurie's pediatric ICU.
Intermediate-care units, also called step-down and transitional-care units, have been around for decades, but hospitals use the model in a variety of ways. The pediatric intermediate-care unit at the University of Illinois Hospital is part of the pediatric intensive-care unit. It's staffed based on acuity; "one shift isn't the same as the next shift," said Jamie Ghafari, director of pediatrics and pediatric intensive care at U of I Hospital.
Lurie started piloting the dedicated intermediate-care unit in 2016, which was "our first time carving out a separate level of care between the intensive-care unit and the acute-care floors," said Dr. Irini Kolaitis, the unit's medical director. The model improved patient outcomes, decreased length of stay and enabled the hospital to accommodate more patients, she said.
The findings are on par with a recent analysis of step-down units in 10 California-based hospitals operated by Kaiser Permanente.
For Lurie, whose full name is the Ann & Robert H. Lurie Children's Hospital of Chicago, the ability to care for more patients was one of the most appealing benefits.
"There are a lot of patients who are seeking transfer from other organizations that are critically ill, so trying to accommodate them is a big challenge we face daily on a daily basis," Kolaitis said. "One of the answers to that was to bring more beds online. The second thing we're hoping to do with this unit is trying to more appropriately use our space, so choosing the right area in the hospital for every patient that comes in."
The Illinois Health Facilities & Services Review Board, which evaluates all applications for the construction or expansion of health-care facilities and approved Lurie's plan, doesn't have a specific category for intermediate-care units.
"Lurie to open intermediate-care unit" originally appeared in Crain's Chicago Business.