Intensive care unit (ICU) patients were randomly assigned to either a
traditional ICU or a special care unit (SCU) for chronically criticall
y ill patients. The SCU used a low-technology, family-oriented environ
ment, nursing care management, no physician house staff, and a shared
governance model. In comparison, the ICU used high technology, limited
family visiting, primary care nursing, and a bureaucratic management
model. The survival experience of chronically critically ill patients
in the two environments during hospitalization, as well as after hospi
tal discharge, was examined. Using survival analytic techniques, the 1
-year cumulative mortality for all patients in the study was found to
be 59.9%. Risk of death was significantly lower after discharge than d
uring hospitalization. Similar mortality experiences were found for SC
U and ICU patients. Thus, the high-technology ICU environment did not
produce better outcomes than the SCU environment.