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Written by Dr. M. Malik
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Wednesday, 02 April 2008 14:19 |
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The History of Riyadh Military Hospital ICU Up until 2004, GICU in the Riyadh Military Hospital was under the department of anaesthesia who were coming in on rotation basis. It was a 16 bed medical/surgical unit which tried to cater to the needs of the 1200 bed tertiary care military hospital. It had only two isolation rooms and an eight bed long term ventilation unit. The design of that unit was also ‘old fashioned’. Four patients were used to cohort in one small room so the cross infection rate was very high. At that time, there was no ICU admission policy for the unit. Every patient in the hospital, who became unstable, regardless of his co morbidities, was eligible for admission to the ICU. Multiple drug resistant infections were common at that time. This problem became so intense that we had to stop new admissions, especially to the clean surgical patients. As our hospital is the biggest tertiary care military hospital in the Kingdom, we are under an intense burden to accept critical care patients from other hospitals to provide advanced and latest healthcare. Due to the shortage of isolation rooms, our Medivac acceptance rate was 31 admissions in 2004. The average ICU admission and mortality rate was 599 and 32.7% in 2004. The reason for this is that there was no permanent staff assigned to the ICU. Nobody bothered to do long-term planning and to find the solution for the problems.
By the end of 2004, permanent staff that were qualified and well trained in intensive care were assigned. They analyzed the situation for the next 6 months and identified the problems and after that, they started addressing these issues, one by one. They introduced and implemented the ICU admissions policies. This produced a big difference in the ICU management. Only deserving and viable patients were admitted into the unit, which resulted in an increase in the admission rate and improved the outcome of the patients as well.
One of the problems identified was space and the equipment. This was addressed by planning a new 45 bed ICU with all the latest equipment. ICU management in the leadership of the ICU director started working on it in 2005 and with the tireless effort of his team; they opened a new icu, well equipped with all the latest gadgetries in March 2007. This included the rotoprone bed, high frequency oscillators, non invasive cardiac output monitors and state of the art ventilators and bedside monitors.
The next step was healthcare staff training and education. This was addressed by lectures, short intensive care for nurses and respiratory therapists. They also introduced the famous Fundamentals of Critical Care Support and Fundamentals of Disaster Management courses by the Society of Critical Care Medicine. These things improved the educational training level in our health care staff which now matches the International standards.
Research and database was another corner which was neglected. We immediately established a computerized database and employed a full time person to look after it. This data base helped us in identifying areas which needed special attention. It also laid the seed for research. With the help of this, many studies were initiated. Some of them were presented in the International conference in Belgium and Dubai.
Dr. Muhammad Kashif Malik
MCPS, FCPS
Intensivist, Anaesthetist
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Our History
