Page 169 - Hospital Authority Convention 2018

Masterclasses

M13.3 Advances in Intensive Care 13:15 Convention Hall A

Designing a Modern Intensive Care Unit – from a Doctor’s Perspective
Tsang HH
Intensive Care Unit, Kwong Wah Hospital, Hong Kong
Intensive care medicine emerged with the systematic management of poliomyelitis victims suffering from respiratory failure HOSPITAL AUTHORITY CONVENTION 2018
in the 1950s. Large numbers of patients had a life-threatening medical problem: acute respiratory failure, for which there was
a high tech treatment strategy — the iron lung respirator. By placing these patients in a common hospital setting — among
the earliest intensive care units (ICUs) — effective medical care could be administered more efficiently by experts using
highly specialised equipment and providing comprehensive standardised care. Expansive open wards that housed the many
poliomyelitis patients and their ventilators illustrated the systematic approach applied to the problem but these early “ICUs”
bear little resemblance to modern ICUs.

Nowadays, ICUs are equipped with sophisticated life-supporting devices and specialists of multiple disciplines, where
critically ill patients with multiple organ dysfunction are supported.
Designing a modern ICU is a time-consuming, complex, multi-phased, political, and costly exercise. Earlier ICU design placed
substantial emphasis on monitoring and direct observation of patients in all ICU beds from a central station. Therefore, ICU
beds were often in open areas separated only by curtains to be drawn as needed to provide privacy. This approach had clear
trade-offs with patient privacy, comfort, and infection control.

In the modern era of critical care, more emphasis is placed on creating a healing environment of care. The form and function
of the modern ICU room should be designed to meet the dual needs of effective patient care for life-threatening illness and
injury and of a supportive environment for healing and well-being of patients, visitors, and staff.
The most substantial change in modern ICUs has been the progressive integration of information systems and the vast
array of electronic devices. The goal is for comprehensive electronic integration of the patient with all aspects of care and
transformation of patient-related data into useful and actionable information. Systems for data management and decision
support of electronic medical record data are developed to enhance the quality and efficiency of patient care. Tuesday, 8 May 2018

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