Little other than subjective clinical judgment is available to help clinicians determine when a patient should be transferred out of the intensive care unit (ICU).
The criterion of no longer requiring care that can be supplied only in the ICU seems straightforward to apply for mechanical ventilation and vasopressors, but less so for many interventions that are used in ICUs but are often performed outside of them as well.
The decision about the need for ICU nursing care is largely subjective.
As in other domains of clinical judgment in the ICU, large individual variation between physicians is likely.
In addition, bed availability can influence when patients leave the ICU.
Admissions when the ICU is fully occupied can result in patients being transferred out before the physician would like, whereas limited availability of beds in step-down areas can lead to transfer occurring later than desired.