ICU command centres in critical care: Nursing workflows, organizational models, and implementation challenges. A narrative review.

Abstract

Objectives: To synthesize current evidence on ICU Command Centers as socio-technical systems that support real-time clinical coordination, data-driven resource allocation, and interdisciplinary workflows, with particular emphasis on implications for critical care nursing practice.

Methods: A narrative review of peer-reviewed articles and gray literature published from 2005 to 2024 was conducted through PubMed, Embase, and Web of Science, as well as institutional reports. Findings were grouped thematically across five domains: clinical impact, operational efficiency, enabling technologies, barriers to implementation, and case examples. Nursing-related outcomes were specifically highlighted.

Results: Authoritative ICU Command Center models are associated with improved adherence to best practices, reduced ICU mortality and length of stay, and enhanced operational efficiency. Platforms integrating predictive dashboards and remote expert support improve staff responsiveness and reduce documentation burden. For nurses, Command Centers may reduce alarm fatigue, streamline workflows, and enhance team communication-especially when systems are tailored to frontline needs.

Conclusions: ICU Command Centers represent a scalable, data-driven infrastructure for high-acuity care. Their impact depends on alignment with clinical workflows, especially those of nurses, and on trust-building strategies that promote adoption and sustained use.

Implications for clinical practice: When integrated effectively, ICU Command Centers can reduce cognitive overload and optimize nursing care by supporting prioritization, protocol adherence, and interdisciplinary coordination. Involving nurses in the design and implementation phases is key to ensuring usability and clinical relevance.