The Vicious and Virtuous Facets of ICU Structure

Background: In the provision of medical facilities, intensive care units are very critical and it seems almost difficult to use the new therapeutic strategies without Intensive Care Unit (ICU). There are two types of ICU structure, known as the open or closed model. The aim of this study was to assess the variables driving the selection of the appropriate ICU management structure and modeling of the appropriate ICU management structure. Methods: This descriptive-exploratory study was performed among all resident doctors, consultants, therapists and neurosurgeons, ICU specialists, internal medicine specialists, respiratory diseases specialists, heads of associated units and head nurses, neurosurgery ICU workers and staff, and doctors of the Loghman Hakim Hospital in Tehran, Iran in 2018. The influence of independent variables on dependent variables and the effect of observed variables on latent variables were tested using the Structural Equation Technique (SEM technique) and the data collected in the LISREL program was analyzed. Results: This research included one hundred persons, including 91 men and 9 women. The factors affecting the performance and structure of the ICU were structural context (including open, semi- closed, and closed structure), organizational context, strategic context, treatment economics context, processes, and quality improvement. Conclusion: There is a good association between quality management and the application of the closed system of the ICU and each of the organizational, strategic, care economics, and processes factors.