Planning a Level Two Unit for Medical Patients: A Prospective Study

Critical care provision in the UK is evolving, driven by increased patient expectations, increased resource, restructuring of trusts and changes to the way health care is funded. Part of this recent change is reflected in an increase in demand for level 2 beds. The John Radcliffe Hospital in Oxfordshire is a teaching hospital with over 700 inpatient beds and several on-site specialised critical care units, but no dedicated level 2 unit. Level 2 care for general medical patients is provided in the 16-bed adult intensive care unit (ICU). We performed a prospective study to allow for planning of a level 2 medical unit, by collecting data on candidates for level 2 care over a 57-day period. We identified 157 medical patients who required a total of 222 bed-days. We calculated that a six-bedded unit would run at full capacity for 88% of the time. This study could be performed in any hospital that needs level 2 care facilities, and could be modified to include surgical patients.