Skip to main content

Changing ICU Behavior To Focus On Long Term Outcomes

  • Conference paper
Surviving Intensive Care

Part of the book series: Update in Intensive Care Medicine ((UICMSOFT,volume 39))

Abstract

Implicit in the title of this chapter is the belief that currently in the intensive care unit (ICU), our focus is restricted to short term outcomes. We hypothesize that there are several reasons for this. The appellation of critical care medicine underscores the serious illnesses from which most of our patients suffer. We provide advanced life support of a technological and pharmacological nature in the ICU, resuscitating and stabihzing patients. We invasively and non-invasively monitor physiology, usually intervening in an effort to normalize pathophysiology. Traditionally, critical care interventions have been highly intensive, expensive and brief, ending when patients are discharged from the ICU.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cook DI (1998) Caring for critically ill patients: Past, present and future JAMA 280181–182

    Article  PubMed  CAS  Google Scholar 

  2. Ellrodt AG, Cook DJ, Lee I, Cho M, Hunt D, Weingarten S (1997) Evidence-based disease management JAMA 2781687–1692

    Article  PubMed  CAS  Google Scholar 

  3. Chen LM, Martin CM, Keenan SP, Sibbald WJ (1998) Patients readmitted to the intensivd care unit during the same hospitalization: Clinical features and outcomes Grit Care Med 261834–1841

    Article  CAS  Google Scholar 

  4. Heyland DK, Guyatt GH, Cook DJ, et al (1998) Frequency and méthodologie rigor of quality-of-life assessments in the critical care literature Crit Care Med 26591–598

    Article  PubMed  CAS  Google Scholar 

  5. Gracey DR, Gillespie D, Nobrega F, et al (1987) Financial implications of prolonged ventilator care of Medicare patients under the prospective payment system: A multicenter study Chest 91424–427

    Article  PubMed  CAS  Google Scholar 

  6. Suter P, Armagandis A, Beautils F, et al (1994) Predicting outcome in ICU patients. European Consensus Conference Report Intensive Care Med 20390–397

    Article  Google Scholar 

  7. Rubenfeld DG, Curtis JR for the End-of-Life Care in the ICU Working Group (2001) End of life care in the intensive care unit: A research agenda Crit Care Med 292001–2006

    Article  PubMed  CAS  Google Scholar 

  8. Davidson TA, Caldwell ED, Curtis IR, et al (1999) Reduced quality of life in survivors of acute respiratory distress syndrome compared with critically ill control patients JAMA 281354–360

    Article  PubMed  CAS  Google Scholar 

  9. Herridge MS, Cheung AM, Tansey C, et al (2001) Long term clinical outcomes in survivors of ARDS Am J Resp Crit Care Med 163:A253 (abst)

    Google Scholar 

  10. DeJonghe BD, Cook DJ, Sharshar T, LeFaucheur JP, Carlet J, Outin H (1998) Neuromuscular disorders in critically ill patients: A systematic review Intensive Care Med 241242–1250

    Article  CAS  Google Scholar 

  11. Cook DJ, Meade MO, Perry AG (2001) Qualitative studies on the patient’s experience of weaning from mechanical ventilation Chest 120 (Suppl 6)469S–473S

    Article  PubMed  CAS  Google Scholar 

  12. Bero LA, Grilli R, Grimshaw JM, et al (1998) Closing the gap between research and practice: An overview of systematic reviews of interventions to promote the implementation of research findings Br Med J 317465–468

    Article  CAS  Google Scholar 

  13. Grimshaw J, Freemantle N, Wallace S, et al (1995) Developing and implementing clinical practice guidelines Qual Health Care 455–64

    Article  PubMed  CAS  Google Scholar 

  14. Oxman AD, Thomson MA, Davis DA, et al (1995) No magic bullets: A systematic review of 102 trials of interventions to improve professional practice Can Med Assoc J 1531423–1431

    CAS  Google Scholar 

  15. Davis D, Thompson-O’Brien MA, Freemantle N, et al (1999) Impact of formal continuing medical education: Do conferences, workshops, rounds and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 82867–874

    Article  Google Scholar 

  16. Soumerai SB, Avorn J (1990) Principles of educational outreach (‘academic detailing’) to improve clinical decision making JAMA 263549–556

    Article  PubMed  CAS  Google Scholar 

  17. Hunt DL, Haynes RB, Hanna SE, et al (1998) Effects of computer-based clinical support systems on physician performance and patient outcomes: A systematic review JAMA 2801339–1346

    Article  PubMed  CAS  Google Scholar 

  18. Kiefe CI, Allison JJ, Williams OD, et al (2001 ) Improving quality improvement using achievable benchmarks for physician feedback: A randomized controlled trial JAMA 2852871–2879

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

McMullin, J., Cook, D. (2003). Changing ICU Behavior To Focus On Long Term Outcomes. In: Angus, D.C., Carlet, J. (eds) Surviving Intensive Care. Update in Intensive Care Medicine, vol 39. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55733-0_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-55733-0_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-44149-6

  • Online ISBN: 978-3-642-55733-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics