• Andrew S Geneslaw, Haomiao Jia, Adam R Lucas, Agus Michael S D MSD Division of Medicine Critical Care, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States. Elec, and Jeffrey D Edwards.
• Division of Pediatric Critical Care Medicine, Department of Pediatrics, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital, 3959 Broadway, New York, NY 10032, United States. Electronic address: ang2021@nyp.org.
• J Crit Care. 2017 Oct 1; 41: 268-274.

PurposeTo examine how intermediate care units (IMCUs) are used in relation to pediatric intensive care units (PICUs), characterize PICU patients that utilize IMCUs, and estimate the impact of IMCUs on PICU metrics.Materials & MethodsRetrospective study of PICU patients discharged from 108 hospitals from 2009 to 2011. Patients admitted from or discharged to IMCUs were characterized. We explored the relationships between having an IMCU and several PICU metrics: physical length-of-stay (LOS), medical LOS, discharge wait time, admission severity of illness, unplanned PICU admissions from wards, and early PICU readmissions.ResultsThirty-three percent of sites had an IMCU. After adjusting for known confounders, there was no association between having an IMCU and PICU LOS, mean severity of illness of PICU patients admitted from general wards, or proportion of PICU readmissions or unplanned ward admissions. At sites with an IMCU, patients waited 3.1h longer for transfer from the PICU once medically cleared (p<0.001).ConclusionsThere was no association between having an IMCU and most measures of PICU efficiency. At hospitals with an IMCU, patients spent more time in the PICU once they were cleared for discharge. Other ways that IMCUs might affect PICU efficiency or particular patient populations should be investigated.Copyright © 2017 Elsevier Inc. All rights reserved.

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