The role of stepdown beds in hospital care.

Publisher: American Thoracic Society Country of Publication: United States NLM ID: 9421642 Publication Model: Print Cited Medium: Internet ISSN: 1535-4970 (Electronic) Linking ISSN: 1073449X NLM ISO Abbreviation: Am J Respir Crit Care Med Subsets: MEDLINE

Publication: 2000- : New York, NY : American Thoracic Society
Original Publication: New York, NY : American Lung Association, c1994-

Continuity of Patient Care/*standards ; Critical Care/*methods; Continuity of Patient Care/economics ; Continuity of Patient Care/organization & administration ; Cost Control/methods ; Critical Care/economics ; Critical Care/organization & administration ; Cross-Cultural Comparison ; Humans

Stepdown beds provide an intermediate level of care for patients with requirements somewhere between that of the general ward and the intensive care unit. Models of care include incorporation of stepdown beds into intensive care units, stand-alone units, or incorporation of beds into standard wards. Stepdown beds may be used to provide a higher level of care for patients deteriorating on a ward ("step-up"), a lower level of care for patients transitioning out of intensive care ("stepdown") or a lateral transfer of care from a recovery room for postoperative patients. These units are one possible strategy to improve critical care cost-effectiveness and patient flow without compromising quality, but these potential benefits remain primarily theoretical as few patient-level studies provide concrete evidence. This narrative review provides a general overview of the theory of stepdown beds in the care of hospitalized patients and a summary of what is known about their impact on patient flow and outcomes and highlights areas for future research.

Comment in: Am J Respir Crit Care Med. 2015 May 1;191(9):1089-90. (PMID: 25932770)

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K08 AG038477 United States AG NIA NIH HHS; K08AG038477 United States AG NIA NIH HHS

Keywords: continuity of patient care; critical care; intensive care unit; intermediate care

Date Created: 20140828 Date Completed: 20150123 Latest Revision: 20220330

20221213

PMC4315815

10.1164/rccm.201406-1117PP

25163008