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Setting the Goals

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Critical Care Administration

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Abstract

Herein, we detail some of the issues related to the organization and staffing of a modern ICU. This is evaluated from both the practitioner’s viewpoint and that of the institution. We present some of the innovations we have developed in this arena.

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Notes

  1. 1.

    Retrospective analysis of the SCCMs Project IMPACT national database. This had significant limitations, perhaps the most significant on being that it was not always possible to determine whether patients had been cared for by intensivists or not (Reference # 12, page 808).

  2. 2.

    For example, over an approximate 8- to 12-month period, the Department of Critical Care Medicine developed Service Line Standards. These were distributed and discussed over 3 months at our system-wide CCM meetings. In January 2014, they were formally approved by our multicampus and multi- and interdisciplinary committee and sent to MLC for approval. Those not taking part in the multi-month process when they were asked for input cannot be allowed to holdup the process of implementation. ICU standards were ultimately put into effect but were, indeed, held up for almost 12 months by individuals who had not taken part. This health system leadership issue was poorly handled in our institution.

References

  1. Markandaya M, Thomas KP, Jahrommi B, et al. The role of neurocritical care – a brief report on the survey results of neurosciences and critical care specialists. Neurocrit Care. 2012;16:72–81.

    Article  Google Scholar 

  2. Bukur M, Habib F, Catino J, et al. Does unit designation matter ? A dedicated trauma intensive care unit is associated with lower postinjury complication rates and death after major complication. J Trauma Acute Care Surg. 2015;78:920–9.

    Article  Google Scholar 

  3. Mirski MA, Chang CWJ, Cowan R. Impact of a neuroscience intensive care unit on neurosurgical patient outcomes and cost of care. J Neurosurg Anesthesiol. 2001;13:83–92.

    Article  CAS  Google Scholar 

  4. Diringer MN, Edwards DF. Admission to a neurologic/neurosurgical intensive care unit is associated with a decreased mortality after intracerebral hemorrhage. Crit Care Med. 2001;29:635–340.

    Article  CAS  Google Scholar 

  5. Webb DJ, Fayad PB, Wilbur C, Thomas A, Brass LM. Effects of a specialized team on stroke care – the first two years of the Yale Stroke Program. Stroke. 1995;26:1353–7.

    Article  CAS  Google Scholar 

  6. Wentworth DA, Atkinson RP. Implementation of an acute stroke program decreases hospitalization costs and length of stay. Stroke. 1996;27:1040–3.

    Article  CAS  Google Scholar 

  7. Varelas PN, Conti MM, Spanaki MV, et al. The impact of a neurointensivist-led team on a semiclosed neurosciences intensive care unit. Crit Care Med. 2004;32:2191–8.

    Article  Google Scholar 

  8. Suarez JI, Zaidat OO, Suri MF, et al. Length of stay and mortality in neurocritically ill patients – impact of a specialized neurocritical care team. Crit Care Med. 2004;32:2311–7.

    Article  Google Scholar 

  9. Grieve R, Sadique Z, Gomes M, et al. An evaluation of the clinical and cost-effectiveness of alternative care locations for critically ill adult patients with acute traumatic brain injury. Br J Neurosurg. 2016;30(4):388–96.

    Article  CAS  Google Scholar 

  10. Bershad EM, Feen ES, Hernandez OH, Suri MFK, Suarez JI. Impact of a specialized neurointensive care team on outcomes of critically ill acute ischemic stroke patients. Neurocrit Care. 2008;9:287–92.

    Article  Google Scholar 

  11. Levy MM, Rapoport J, Lemeshow S, Chalfin DB, Phillips G, Danis M. Association between critical care physician management and patient mortality in the intensive care unit. Ann Intern Med. 2008;148:801–9.

    Article  Google Scholar 

  12. Lott JP, Iwashyna TJ, Christie JD, Asch JD, Kramer AA, Kahn JM. Critical illness outcomes in specialty versus general intensive care units. Am J Respir Crit Care Med. 2009;179:676–83.

    Article  Google Scholar 

  13. Blumenthal D, Stremikis K, Cutler D. Health care spending – a giant slain or sleeping? N Engl J Med. 2013;369(26):2551–7.

    Article  CAS  Google Scholar 

  14. McGlynn EA, Asch SM, Adams J. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635–45.

    Article  Google Scholar 

  15. Reif S, Korzick K, Layon A. (1207) An ICU Reader Program to Decrease Delirium Days. Crit Care Med. 2018;46(1):587. (For the 47th Society of Critical Care Medicine, Annual Congress, San Antonio, Texas.)

    Article  Google Scholar 

  16. McCusker J, Cole M, Abrahamowicz M, et al. Environmental risk factors for delirium in hospitalized older people. J Am Geriatr Soc. 2001;49:1327–34.

    Article  CAS  Google Scholar 

  17. Girard TD, Pandharipande PP, Ely EW. Delirium in the intensive care unit – review. Crit Care. 2008;12(Suppl 3):S3. https://doi.org/10.1186/cc6149.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Snell K, Rekha RM, Herring M, Hussein R, Korzick K, Layon A. (1212) Post-Intensive Care Unit Clinic (PICUC) Role In Decreasing 60-Day Readmissions – A Prospective Study. Crit Care Med. 2018;46(1):590. (For the 47th Society of Critical Care Medicine, Annual Congress, San Antonio, Texas).

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Geisinger Medical Center, Danville, PA, USA

    Mary Jane Reed

  2. University of Central Florida College of Medicine, Orlando, FL, USA

    A. Joseph Layon

Authors
  1. Mary Jane Reed
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  2. A. Joseph Layon
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Editor information

Editors and Affiliations

  1. Division of Critical Care, Karl Heusner Memorial Hospital, Belize City, Belize

    Jorge Hidalgo

  2. Department of Critical Care Services, Baptist Hospital of Miami, Miami, FL, USA

    Javier Pérez-Fernández

  3. Department of Critical Care and Neurocritical Care, HIMA-San Pablo, Caguas, Puerto Rico

    Gloria Rodríguez-Vega

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Reed, M.J., Layon, A.J. (2020). Setting the Goals. In: Hidalgo, J., Pérez-Fernández, J., Rodríguez-Vega, G. (eds) Critical Care Administration. Springer, Cham. https://doi.org/10.1007/978-3-030-33808-4_3

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  • DOI: https://doi.org/10.1007/978-3-030-33808-4_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33807-7

  • Online ISBN: 978-3-030-33808-4

  • eBook Packages: MedicineMedicine (R0)

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