ICU-BIS Background
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It was essential to make optimal use of ICU bed capacity in Irish hospitals and this required real-time monitoring of ICU bed capacity and occupancy. NOCA was already progressing a project to provide this information when the Covid pandemic occurred in Dec 2019 in Wuhan. With support from the HSE and by prioritising this project within NOCA and DMF Systems (NOCA’s Information Technology (IT) provider for ICU Audit), the ICU Bed Information System (BIS) was developed speedily and went live on 26th March 2020.
Despite cyber-attacks, lockdowns and further waves the ICU-BIS has reported its data to the HSE daily 365 days a year. This is to the credit of all the staff in the Intensive Care Units who update even when under pressure every morning and are supported by the Data collectors who support the units and the ICU-BIS.
ICU-BIS provides data on the numbers of ICU beds open, ICU beds occupied and ICU beds available. It also provides data on the impact of COVID-19 on ICU, i.e. numbers of new admissions of COVID-19 cases to ICU, numbers of COVID-19 patients in ICU, and numbers of discharges and of deaths in ICU of COVID-19 patients. Data are also collected on the numbers of patients’ invasively ventilated and undergoing renal replacement therapy (RRT).
ICU-BIS is a valuable resource for clinicians trying to find an ICU bed when their own unit is full.
A key role for the NOCA ICU Bed Information System (BIS) is to provide daily data on the capacity of the healthcare system to care for critically ill patients. This included data on ICU bed occupancy and bed availability and on the situation in individual hospitals, especially those approaching their peak ICU capacity.
The ICU-BIS data is updated at least once a day on the ICU-BIS website, providing up to date information on the ICU bed occupancy. A designated user in each of the participating hospitals enters the data. The data items are limited, to provide key date without excessive burden on the busy clinical staff entering the data. There are definitions and guide text for users to ensure consistent and accurate data entry. Each hospital can assign appropriate staff to update as fits their needs.
ICU-BIS is supported by NOCA seven days a week, to ensure completeness and accuracy of data. This support involves phoning units that have not entered data or where data differs from expected. NOCA staff may ring to obtain further details which are important for epidemiological purposes.
The ICU-BIS was used by staff to identify available beds after the explosion in Creeslough Co. Donegal in Oct 2022 and the Wexford fire in April 2023.
At times the HSE will request further information eg when paediatric hospitals had a surge due to RSV the Data Collectors reported the details to the SDU of the HSE for the duration of the surge.