An Intermediate Care Unit (IMCU) is a vital part of the healthcare system, serving as an essential link between a hospital’s Intensive Care Unit (ICU) and the general ward. Intermediate care units are designed to provide an intermediate level of care that’s not long-term. Therefore, it operates between the ICU and general ward and can function as a physically independent unit or as a dedicated section within an ICU.
They are sometimes referred to as “step-up” or “step-down” units, as they provide a stepping stone for patients ready to leave the ICU but not yet ready to be discharged to the general ward.
In addition to this, they can also be referred to as:
- High Dependency Units
- Progressive Care Units
- Medium Care Units
- High Care Units
- Transitional Care Units
- Special Care Units
- Subintensive Care Units
- Semi-Intensive Care Units
However, the term “Intermediate Care Unit” is considered to be the most appropriate, as it accurately reflects the logistic position of the unit in the hospital.
A study by Critical Care Research and Practice found that the terms “Intermediate Care Units” and “High Dependency Units” are primarily used in Europe and the east coast of the United States and that these facilities primarily serve surgical patients (89.2%), with some also treating medical patients (35.1%). As for the management format of an intermediate care unit, it is split between open (56.7%)—where the attending specialist is in charge—and closed (43.3%)—where an intensivist is in charge.
The study also found that IMCUs are typically located adjacent to the ICU (37.0%) or in a separate location (40.7%). The number of beds in IMCUs ranges from 2 to 24, with a median of 6, and the median nurse-to-patient ratio is 1 to 2.5.
IMCU care always includes hemodynamic monitoring and respiratory support to aid monitoring or treatment modules. Other modalities that can be incorporated into an IMCU to meet hospital-specific needs vary widely, making it vital for hospitals to consider their specific needs when designing and operating an intermediate care unit.
Next, we will look at intermediate care, intermediate care facilities, and how intermediate care facilities compared to skilled nursing facilities.
Intermediate Care Facility vs. Skilled Nursing Facility
Before we dive into intermediate care facility vs. skilled nursing facility, we must first explain the difference between “intermediate care” and an intermediate care unit.
Intermediate care is an emerging concept in healthcare, but due to a lack of internationally agreed-upon consensus, confusion abounds as to what the term means. Generally speaking, intermediate care serves as an alternative to hospital admission or an alternative option that allows people to leave a hospital sooner. It may be provided in a home setting, residential or nursing home, or other health and social care facilities.
At its most basic level, intermediate care:
- Helps people maintain their existing levels of independence
- Provides only necessary medical, therapeutic, and other support
- Individualizes care to meet each person’s specific needs
- Provides services from
- Doctors
- Nurses
- Physiotherapists
- Occupational therapists
- Speech and language therapists
- Dietitians
- Social workers
- Psychologists and psychiatrists
The goal of intermediate care is for individuals to regain their maximum level of independence with the right support network. Thus, with this definition in mind, we can establish that intermediate care does not relate to an intermediate care unit.
Intermediate care facilities (ICFs), meanwhile, are health and social settings designed to provide custodial care for those who cannot look after themselves due to physical or mental disability. They offer less intensive alternatives to hospital stays, with a wide range of services for the disabled, elderly, and other patients.
ICFs provide medical treatment and therapeutic approaches tailored to meet the needs of each patient. In addition to addressing conditions through specialist treatments, ICFs focus on helping patients regain their maximum level of independence with assistance from an appropriate support network.
If we compare ICFs vs. SNFs, the differences would be in:
- Level of care provided: SNFs offer more comprehensive medical care than ICFs, as they are staffed with licensed medical professionals such as doctors, nurses, and therapists. ICFs may also offer some medical care, but their primary focus is on providing custodial and social support to patients.
- Primary population served: SNFs serve both short-term and long-term residents who are recovering from an illness or injury and may require rehabilitative care. ICFs typically serve patients with chronic conditions or those with mental or physical infirmities who require long-term custodial support.
In conclusion, intermediate care facilities and skilled nursing facilities are two distinctive types of health settings that provide different levels of medical care to support individuals with differing needs. ICFs focus on helping patients—especially those with mental or physical infirmities—regain their maximum level of independence, while SNFs offer more comprehensive medical treatment options.
Both can be beneficial for those who need a combination of custodial and rehabilitative services. Still, it’s essential to understand their differences before deciding which type is best suited for your or a loved one’s needs. Ultimately, the decision should be made based on an individual’s unique situation and what works best for them in terms of quality care and convenience.
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Intermediate Care Facilities For The Developmentally Disabled
According to the Department of Developmental Services of the State of California, intermediate care facilities for the developmentally disabled are designed to offer round-the-clock assistance with personal care, habilitation, developmental support, and health services to clients with developmental needs who require occasional skilled nursing care.
Note that these are different from an intermediate care unit. Other intermediate care examples of intermediate care facilities include the following:
- Intermediate care facility/developmentally disabled-habilitative: This is a type of facility that offers 24/7 personal care, habilitation, developmental support, and health services to a maximum of 15 individuals with developmental disabilities who have occasional recurring needs for nursing care services but have been certified by a physician as not requiring constant skilled nursing services. This facility typically has four to 15 beds available.
- Intermediate care facility/developmentally disabled nursing: For these facilities, they offer 24-hour personal care, developmental services, and nursing supervision to individuals with developmental disabilities who require occasional skilled nursing care but do not need constant skilled nursing services. These facilities typically have a capacity of four to 15 beds. They are intended to serve individuals who are medically fragile and have developmental disabilities or are at risk of developing them without proper treatment.
At this point, one should now understand the difference between intermediate care facility vs. skilled nursing facility. Also, one should understand the different types of intermediate care facilities, one of which is the intermediate care facility for the developmentally disabled. As we conclude on this topic of intermediate care and intermediate care units, we will look at an intermediate care unit and its benefits.
The Benefits of an Intermediate Care Unit
An intermediate care unit plays an important role in the healthcare system by doing the following:
- Providing extra ICU capacity
- Allowing for earlier discharge of some ICU patients
- Providing an alternative to ICU admission for patients who only require intensive monitoring, specific support, or procedures.
In these ways, an intermediate care unit not only benefits patients but healthcare providers as well, as it can help reduce the burden on ICUs, lower healthcare costs, and improve patient outcomes.
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