Chest
Volume 93, Issue 2, February 1988, Pages 390-394
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ACCP Council on Critical Care
Noninvasive Respiratory Care Unit: A Cost Effective Solution for the Future

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THE CONCEPT OF INTENSIVE CARE

The first intensive care unit was reportedly created in Scandinavia in 1952 in response to the epidemic of poliomyelitis.15 Large numbers of patients with respiratory failure were concentrated in specialized units and given uniform therapy. The result was a marked improvement in survival.

The initial intensive care units in the United States began with the concept of a single unit to handle the critically ill patients of the entire institution. However, it soon became apparent that the different

RATIONALE FOR THE NONINVASIVE RESPIRATORY CARE UNIT

A recent study has demonstrated that 40 percent of medical intensive care unit (MICU) and 30 percent of surgical intensive care unit (SICU) patients were admitted strictly for monitoring purposes and did not receive any active intervention.9 Additional reports have confirmed that a significant number of ICU patients are admitted purely for monitoring purposes and were not suffering from life-threatening processes.10 These patients fill the more expensive ICU beds and consume the precious

THE RPSLMC NONINVASIVE RESPIRATORY CARE UNIT

The Rush-Presbyterian-St Luke's Medical Center noninvasive respiratory care unit is an eight-bed specialty unit that incorporates the team approach to medical care. The unit has a medical director who has the basic responsibility of leading the patient care team. The director also guides the management and weaning of the patients in addition to having the final say in regard to the triage of patients for the unit. The other members of the team include the medicine housestaff, who directly

CONCLUSIONS

The noninvasive respiratory care unit is an unique application of past concepts into today's economic climate in an attempt to more judiciously utilize the limited health care resources. The goal is to provide the same or better quality health care and allow for a reduction in the cost associated with this care. With the future prospects of an ever-increasing population of elderly patients and continued methods to alter or limit reimbursement patterns, the only real hope for financial stability

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