Improving resource utilization in the intensive care units. A challenge for Saudi Hospitals.

In the face of increasing demand of intensive care services in the Kingdom of Saudi Arabia, as well as the high cost of delivering such services, systematic steps must be undertaken in order to ensure optional utilization and fair allocation of resources. Strategies start prior to intensive care units (ICU) admission by the proper selection of patients who are likely to benefit from ICU. Less resource-demanding alternatives, such as intermediate care units, should be used for low-risk patients. Do-not-resuscitate status in patients with no meaningful chance of recovery will prevent futile admissions to ICUs. Measures known to improve the efficiency of care in the ICU must be implemented, including hiring full-time qualified intensivists, switching open units to closed ones and the introduction of certain evidence-base driven management protocols. On discharge, the intermediate care units again play a role as less expensive alternative transitional area for patients who are not stable enough to go to general ward. Measures to reduce re-admissions to ICU must also be implemented. Improving ICU resource utilization requires teamwork not only the intensivists but also the administrators and other health care providers.