Role of Intensive Care Units in Critical Access Hospitals

Funder:	Office of Rural Health Policy (ORHP)
Research center:	North Carolina Rural Health Research and Policy Analysis Center Phone: 919.966.5541
Lead researcher:	Rebecca T. Slifkin, PhD , 919.966.5541, becky_slifkin@unc.edu
Project completed:	February 2005
Topics:	Critical Access Hospitals and Rural Hospital Flexibility Program Health services

The number of small rural hospitals that have chosen to convert to CAH status has been greater than many people had anticipated, and concern has been voiced by some individuals about whether the provision of services in an intensive care unit (ICU) is appropriate in these institutions. As information regarding ICUs in CAHs is currently extremely limited, the purpose of this study is to inform any policy process that aims to affect the provision of ICU services in CAHs.

The study will describe the types of cases treated and services provided, the nursing intensity of the care, and the alternatives (of lack thereof) available to patients. Information will be gathered through telephone interviews with nursing directors at CAHs with ICUs. The study findings will be presented in a working paper and findings brief.

Publications

• Intensive Care In Critical Access Hospitals
  Author(s): Victoria Freeman, Joan Walsh, Matthew Rudolf, Rebecca Slifkin
  Report Number: Working Paper No. 81
  Date: 03 / 2005
  Describes what officials at Critical Access Hospitals (CAHs) mean when they report that they provide intensive care and the importance of these services to the hospital and the community it serves. Semi-structured interviews were conducted with Directors of Nursing at 63 CAHs in 27 states. Respondents described the physical structure of the intensive care area, equipment and staffing available for such care, types of patients who receive intensive care, transfer patterns, the role of intensive care in the decision to convert to CAH status, and the perceived value of this service to the community and hospital.
• Intensive Care in Critical Access Hospitals
  Author(s): Victoria A. Freeman, Joan Walsh, Matthew Rudolf, Rebecca T. Slifkin, Asheley Cockrell Skinner
  Citation: Journal of Rural Health, 23(2), 116-123
  Date: 2007
  Describes the facilities, equipment, and staffing used by Critical Access Hospitals (CAHs) for intensive care, the types of patients receiving ICU care, and the perceived impact of closing the ICU on CAH staff and the local community.