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CCRG and St Andrew’s War Memorial Hospital, in collaboration with industry partners Ascom and Dräger, have made history this month with the opening of the world’s first Silent Intensive Care Unit (ICU).
Article written by the Critical Care Research Group and St Andrew’s War Memorial Hospital, Brisbane.
Watch the video and hear from the people behind the Silent ICU.
Key facts:
1 in 2 Australians will be exposed to an ICU in their lifetime.
Up to 80 per cent of patients experience ICU delirium, a type of acute brain failure, during admission
ICU delirium is caused by multiple factors that disrupt normal brain function, including lack of sleep, inflammation, imbalances in brain chemicals, and reduced oxygen or blood flow to the brain.
The overabundance of alarms in ICU contributes to poor sleep and disruption of normal brain function.
Studies have shown that there is approximately 1 alarm every minute in ICU, with the vast majority not requiring clinical intervention.*
The Silent ICU alarm management solution transfers alarms from medical devices beside the patient head to a distant central monitoring dashboard and mobile devices, removing the medical alarms at the bedside so patients can rest without compromising clinical vigilance.
The launch of the first silent alarm management solution by Ascom and Dräger at St Andrew’s War Memorial Hospital forms part of CCRG’s global ICU of the Future project, redesigning the ICU built environment to be more patient centric and recovery focused.
Research undertaken by the CCRG over the past 8 years shows that the ICU can be an overwhelming environment for patients, family members, and their caregivers, leading to poor short- and long-term outcomes. Patients who develop ICU delirium have a significantly higher chance of developing ongoing psychological, cognitive, and physical problems after ICU admission and increased mortality.
The Silent ICU alarm management solution, delivered with CCRG in collaboration with Ascom and Dräger, transfers important device alarms away from the patient bedside to central dashboards and mobile devices held by relevant clinical staff. This allows clinicians to directly receive actionable alerts and respond appropriately when intervention is required.
Prof John Fraser AO, CCRG Director; Director of ICU, St Andrew’s War Memorial Hospital and Co-Founder of the ICU of the Future said while alarms play a vital role in monitoring patients, the cumulative noise can contribute to extra stress, disturbed sleep, and delirium.
“Intensive care saves lives, but increasingly we are realising that the environment in which that care is delivered also matters. Our patients put their trust in us – it is our job to give them the best care possible, and that must include their acute and chronic mental health” said Prof Fraser.
“Our aim must be to get them home to their loved ones better – not broken. We hope we can reduce delirium and improve sleep and patients’ experience to ensure that our patients thrive, not just survive, when looked after at the St Andrew’s ICU.”
A/Prof Oystein Tronstad, Co-Founder of the ICU of the Future, said the innovation marks a significant shift in how ICUs operate, in a new approach to critical care that puts patient recovery, comfort, and safety at the centre of hospital design.
“Globally, more than 20 million patients are admitted to ICU every year. And while survival rates in Australian ICUs are over 90%, we now understand that the environment in which we care for these patients can contribute to poor outcomes during their hospital admission and after a patient is discharged.
“The ICU of the Future presents a holistic model, enabled by technological innovation and co-designed with patients and their caregivers, of how the built environment can be improved to allow patients to rest and recover better,” said A/Prof Tronstad.
St Andrew’s War Memorial Hospital General Manager, Linda Jorgensen, said that CCRG’s ICU of the Future is a key pillar of the hospital’s broader vision for the future of healthcare, with the silent alarm management solution the next step in this exciting journey.
"At St Andrew’s, we want advances in research and technology to translate into meaningful improvements in the care our patients receive. The Silent ICU alarm management solution is the perfect example turning innovation into practice and importantly helps create an environment where patients will receive the best possible care."
Prior research conducted by the CCRG showed the significant burden that alarms can add to patient recovery whilst in ICU, with at least one new alarm sounding next to the patient’s head every minute. Of the approx. 1,500 alarms a patient will experience in a 24-hour period, the vast majority do not require clinical intervention.
While the term silent ICU describes an environment where bedside medical device alarms can be silenced, it does not mean that clinical alarms are ignored or that the unit operates without sound. Rather, the approach uses integrated technology to direct alerts directly to the clinicians responsible for responding to them.
Gianluca Testasecca, Global Head of Business Development, Ascom said the company had been working for over five years to develop the silent alarm management solution, and they are honoured to be working with CCRG as leaders in critical care research to deliver the project in Brisbane.
“All the noise at the patient bedside coming from the medical devices that are essential for keeping them alive can also detrimentally impact the patient neurologically. The Silent ICU challenges us to think differently about what the ICU should sound like. By using technology to deliver the right information to the right clinician at the right time, we aim towards a calmer environment for patients and families while supporting the teams who care for them.
“At Ascom, we expect this project in Brisbane led by CCRG at St Andrew’s War Memorial Hospital to be the blueprint that is replicated worldwide, and we feel incredibly proud to be part of this ambitious and visionary project,” said Mr Testasecca.
“This initiative shows how we can reimagine and reshape the delivery of care in hospital. At Dräger, we are incredibly proud to be the first patient monitoring company to provide connected medical solutions for silent patient rooms to realise the CCRG’s ICU of the Future,” said Torben Rieder, Dräger Business Development Manager.
“We are extremely proud to be working alongside visionary clinicians and researchers in Australia to reshape the delivery of critical care, to reimagine what the future can look like, and sound like, for ICU patients.”
Lissy Fernandes, Clinical Nurse Manager for St Andrew’s War Memorial Hospital, praised her team for their enthusiasm for the project.
“The launch of the Silent ICU is an important milestone in our ICU of the Future project, reflecting months of dedicated planning, rigorous testing, and collaboration behind the scenes to bring this vision to reality,” said Ms Fernandes.
“By reimagining the environments in which we deliver care, we have an opportunity to create ICUs that are not only clinically advanced, but also help patients sleep, heal, and return home less damaged from their critical illness and ICU experience,” said Prof Fraser.
“That’s the ultimate goal here – to make survival worthwhile.”
As hospitals worldwide look for ways to balance increasingly sophisticated monitoring technology with the human needs of critically ill patients, the launch is expected to generate interest among healthcare leaders, clinicians, researchers, and hospital designers seeking new ways to improve the safety, efficiency, and patient experience of intensive care.
The implementation of CCRG’s ICU of the Future at St Andrew’s War Memorial Hospital has been made possible through the remarkable generosity of a donor. Prof Fraser said the donor's support would have a lasting impact on generations of patients.
"This support has enabled us to lead the way in patient-centred critical care and helping ensure more patients not only survive an ICU admission but go on to thrive afterwards,” said Prof Fraser.
Critical Care Research Group
Headquartered at The Prince Charles Hospital, the Critical Care Research Group brings together clinicians, engineers and scientists to address some of the most complex challenges facing critically ill patients. With an internationally recognised research programme spanning extracorporeal life support (ECMO), mechanical circulatory support, organ preservation, critical care innovation and translational medicine, CCRG is committed to turning research into reality for better patient outcomes globally.
ICU of the Future
Developed by the CCRG, the ICU of the Future is a world-leading initiative designed to improve patient recovery following critical illness by creating intensive care environments that support both clinical excellence and human wellbeing. The model was first implemented at The Prince Charles Hospital in Brisbane in 2022 and has attracted national and international attention for its patient-centred design.
St Andrew’s War Memorial Hospital will be the first private hospital in the world to implement CCRG’s ICU of the Future and the site of the world’s first Silent ICU in partnership with Ascom and Dräger.
St Andrew's War Memorial Hospital
Since 1958, St Andrew's War Memorial Hospital has provided high-quality healthcare in the heart of Brisbane. The hospital is recognised for clinical excellence in cardiac care and orthopaedic surgery, and is a leader in neurosurgery, urology, and other complex specialties. St Andrew’s proudly cares for thousands of patients from across Queensland and beyond each year. Together with The Wesley Hospital, Buderim Private Hospital on the Sunshine Coast, and St Stephen’s Hospital in Hervey Bay, St Andrew’s War Memorial Hospital is part of UnitingCare Queensland’s network of not-for-profit private hospitals.
*Alarm statistics based on monitoring at The Prince Charles Hospital. Only 5% of alarms for monitors were actioned during the observational period.