McManus ML, Long MC, Cooper A, Mandell J, Berwick DM, Pagano M, Litvak E. Variability in surgical caseload and access to intensive care services. Anesthesiology. 2003;98(6):1491-1496.

In health care, demand is often highly variable and access may be limited when peaks cannot be accommodated in a downsized care delivery system. When uncontrolled, variability limits access to care and impairs overall responsiveness to emergencies.

Bristow PJ, Hillman KM, Chey T, et al. Rates of in-hospital arrests, deaths and intensive care admissions: The effect of a medical emergency team. Medical Journal of Australia. Sep 2000;173(5):236-240.

This article describes an Australian study which attempted to evaluate the effectiveness of a medical emergency team (MET) in reducing the rates of selected adverse events.

Leape LL, Cullen DJ, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. Journal of the American Medical Association. 1999;282:267-270.

To measure the effect of pharmacist participation on medical rounds in the ICU on the rate of preventable adverse drug events (ADEs) caused by ordering errors, the authors compared between phase 1 (baseline) and phase 2 (after intervention implemented), and also compared phase 2 with a control unit that did not receive the intervention. The rate of preventable ordering ADEs decreased by 66% during the intervention when pharmacists participated on physician rounds. In the control unit, the rate was essentially unchanged during the same time periods.

Pronovost P, Weast B, Schwarz M, et al. Medication reconciliation: A practical tool to reduce the risk of medication errors. Journal of Critical Care. 2003;18(4):201-205.

This article discusses a study to reduce medication errors in patient's discharge orders through a reconciliation process in an adult surgical intensive care unit (ICU). A discharge survey, initiated within 24 hours of ICU admission and completed on discharge, was implemented as part of the medication reconciliation process. Use of the survey resulted in a dramatic drop in medications errors for patients discharged from an ICU.

Franklin C, Mathew J. Developing strategies to prevent inhospital cardiac arrest: Analyzing responses of physicians and nurses in the hours before the event. Critical Care Medicine. 1994;22(2):244-247.

This article describes a study which attempted to determine: a) the frequency of premonitory signs and symptoms before cardiac arrest in patients on the general medical wards of a hospital; b) any characteristic patterns in nurse and physician responses to these signs and symptoms; and c) whether cardiac arrests on the ward occur more frequently in patients discharged from the medical intensive care unit (ICU) than in other patients.

Coombs M, Dillon A. Crossing boundaries, re-defining care: The role of the critical care outreach team. Journal of Clinical Nursing. 2002;11(3):387-393.

This article makes a case for further study and broader implementation of critical care outreach teams within the NHS health care system in the United Kingdom.

McManus M, Long M, Cooper A, Litvak E. Queuing theory accurately models the need for critical care resources. Anesthesiology. May 2004;100(5):1271-1276.

The stochastic nature of patient flow may falsely lead health planners to underestimate resource needs in busy intensive care units. Although the nature of arrivals for intensive care deserves further study, when demand is random, queuing theory provides an accurate means of determining the appropriate supply of beds.

Pittard AJ. Out of our reach? Assessing the impact of introducing a critical care outreach service. Anesthesia. 2003;58(9):882-885.

This article studies the implementation of a critical care outreach service at a large teaching hospital. After implementation admission to ICU, length of stay, and hospital mortality all demonstrated significant drops.

Sherwood G, Thomas E, Bennett DS, Lewis P. A teamwork model to promote patient safety in critical care. Critical Care Nursing Clinics of North America. 2002;14(4):333-340.

This article argues that to create a safe health care system, providers must understand teamwork as a complementary relationship of interdependence.  In order to accomplish this, the authors stress using an aviation crew resource management approach.

Robson WP. An evaluation of the evidence base related to critical care outreach teams—2 years on from Comprehensive Critical Care. Intensive Critical Care Nursing. 2002;18(4):211-218.

This article contends that even though many hospitals have implemented measures listed within the Comprehensive Critical Care report published two years ago, there is still little evidence to suggest these measures are improving patient outcomes.