In hospitals with traditional organization, i.e. based on specialist departments not organized by intensity of care, patients who are too ill for a general ward, yet do not require intensive care, are sometimes hospitalized in intensive care units, where they receive over-assistance with waste of resources. Otherwise these patients are hospitalized in general wards, where they create distortive effects, attracting most of the health care resources and subtracting assistance to the other patients, while receiving less assistance than needs. To avoid these distortions it is appropriate to create areas of semi-intensive assistance, such as the Critical Area of Internal Medicine. The authors, after review of the literature on the organization of hospital based on intensity of care, underline the advantages of applying these principles not to the entire hospital, but within the Departments or wards of Internal Medicine. Starting from some experiences already carried out spontaneously in some departments with the activation of some monitored beds of semi-intensive therapy, they propose a structured application project for the creation of the critical area of Internal Medicine, by the use of some project management tools (WBS, OBS, Gantt diagram, responsibility matrix, and SWOT analysis).
Keywords: Critical area, Internal medicine, High Dependency Unit (HDU), intermediate care units, critical patients intensity of care, appropriateness of care