Implementation of a Dedicated Resuscitation Bay Within an Acute Care Area

Critically ill patients comprise a large proportion of annual emergency department (ED) visits and require complex, resource-heavy resuscitations. As the volume of high-acuity visits grows annually, there is increasing interest in care models that address the needs of this population without compromising overall departmental flow. This study sought to assess the impact of implementing a dedicated resuscitation bay within an acute care area on the outcomes of high acuity patients.

A dedicated resuscitation bay was implemented within a high-acuity area of an academic, level one trauma center ED. The bay supported resuscitation of a single critically ill patient by consolidating ultrasound, procedural supplies, and a Pyxis with critical care medications into one room. Patients eligible for triage to this area included those with acute trauma, stroke, STEMI, cardiac arrest, unstable arrhythmia, agitation, impending newborn delivery, pediatric airway obstruction, and pediatric status epilepticus. A retrospective cohort study compared patients with these complaints during the 11 months prior to creation of the bay, with those presenting during the nine months after. Descriptive statistics characterized the distribution of chief complaint, Emergency Severity Index (ESI), vital signs, interventions, and ED disposition within groups, while two-sample χ² tests assessed differences between groups in timing of rooming, CT completion, surgical intervention, bed requests, and disposition.

A total of 3,795 patients were included in the analysis. Implementation of a dedicated resuscitation area with triage criteria was associated with a higher proportion of ESI 1 patients in the post-implementation group (36% vs 25%, p<0.001). The dedicated resuscitation area was associated with a decrease in median time to CT scan from 49 to 43 minutes (95% CI −10, −2). There was no significant impact on timing of rooming (95% CI 1, 3), timing of surgical intervention (95% CI −39, 18), or timing of ED disposition (95% CI −8, 36).

The creation of a dedicated resuscitation bay streamlined care for critically ill patients by expediting key interventions such as CT imaging. This intervention demonstrates a potential strategy for consolidating high-acuity patient care into a centralized area, allowing for resource optimization and potential improvement in patient outcomes.