Does suboptimal emergency department care increase intensive care unit cost?
ED-specific data are limited, but research on related areas sheds some light on this question. McQuillan and coworkers [12] conducted a confidential inquiry into the quality of ward care before ICU admission of 100 consecutive adult patients in two UK hospitals and found several areas of concern. Based on methodology used in previous UK confidential inquiries, the authors performed structured interviews of both the ward team and the intensive care team. Emphasis was placed on the recognition and management of abnormalities in five main categories: airway, breathing, circulation, oxygen therapy and monitoring. Interview data were anonymized and sent to two intensivists, who then assessed the quality of care before ICU admission, the appropriateness and timeliness of the ICU admission, and adequacy of management in the five main categories. The assessors agreed that over half of the patients (n = 54) received suboptimal care. Of these 54 patients, 69% were deemed to have been admitted to
