Intermediate Care Units in Internal Medicine.

Area of Science:

• Medical Care
• Critical Care Medicine
• Hospital Management

Background:

• Intermediate Care Units (ImCUs) bridge the gap between standard wards and Intensive Care Units (ICUs).
• General medical ImCUs are specifically designed for high-acuity medical patients.
• This study explores the design, criteria, and quality of care within general medical ImCUs.

Purpose of the Study:

• To investigate the current designs and structures of general medical ImCUs.
• To analyze the appropriateness criteria for patient admission to general medical ImCUs.
• To evaluate the quality of care provided in general medical ImCUs.

Main Methods:

• A systematic literature search was conducted across major electronic databases (PubMed/Medline, Embase, Cochrane, Web of Science).
• Data extraction focused on general medical ImCU denominations, settings, processes, and patient outcomes.
• The search included studies published up to July 30th, 2024.

Main Results:

• 34 studies were analyzed, with 'ImCU' being the most common term (70.6%).
• Key characteristics included a median of 8 beds, a nurse-to-patient ratio of 1:3.1, and 40% internist comanagement.
• Distinct activities involved continuous monitoring and non-invasive ventilation, with a median ICU transfer rate of 8.0%.

Conclusions:

• General medical ImCUs are recognized for managing high-acuity patients but exhibit diverse formats.
• Activity-based admission criteria tailored to hospital needs can optimize patient flow.
• Quality indicators should reflect the ImCU's role within the broader hospital system.