Comparing performance of the intensive care units based on the mortality rate and structural standards in educational hospitals

The aim of intensive care units of the hospitals is decreasing mortality rateand improving health of the society. This study was done with the aim of “studying and comparing the performance of intensive care units by determining mortality rate and finding its relationship with structural situation of these units”. This cross-sectional study was done during six months in 2011 in the intensive care units of educational hospitals inHamedan. The study was done on 200 patients through convenient sampling in the intensive unit of Besat hospital and in two intensive care units of ShahidBeheshti hospital. Data collection tools included SAPS3 checklist that its validity and reliability were confirmed in different studies and a researcher-made structural standards checklist in three areas (human force، physical environment and medical equipment). The ratio of the actual death to the expected death (SMR: standardized mortality rate) was determined by SAPS3 and its relationship with the structural standard score was measured. For data analysis، Kruskal-Wallis، Mann-Whitney، chi-square and Spearman correlation coefficient and SPSS17 software were used. Based on the SAPS3 scoring system، the ration of the actual death to the expected death (SMR) was more than one in all the units of the study which means weak performance; in a way that SMR of Besat، Ghaem and Milad units were respectively; 2. 29، 1. 38 and 1. 56. Structural situation score of the units of the study were also less than 50% of the standard in a way that Besat، Ghaem and Milad units had respectively 48%، 45% and 41% of the structural standards scores. There was no significant relationship between structural standards scores of the units of the study and their SMR performance score (p=0. 66). Performance score of all the three units was weak and regarding structural standards the mentioned units were less than moderate. It is necessary to try to improve structural standards and to decreaseratio of the actual death to the amount of deathexpected by managers، physicians، nurses and other staff of the intensive care units.