Oncologic Critical Care Department Organization

Abstract

Intensive care units (ICUs) are highly complex areas with the delivery of care provided by numerous disciplines with different reporting structures. These multidisciplinary care models are being redesigned as a result of increased emphasis on quality and safety, efficiency, and patient/family experience. The structure and governance of Critical Care departments vary widely in academic medical centers across the United States. Historically, ICUs were governed by individual Critical Care departments with significant focus on education, research, and training. In large centers, there can be several ICUs with completely different structure and organization. The push to improve the quality and safety of care in a streamlined and cost-efficient manner has organizations looking at more innovative ways to structure ICU care models such as institutes or centers. These “Critical Care Organizations” are few in number and are continuing to evolve at the present time. This chapter outlines The University of Texas MD Anderson Cancer Center intensive care unit organizational infrastructure which was designed over a decade and a half ago with the vision to systematically organize, establish, and sustain evidence-based clinical and research initiatives in our oncologic intensive care unit. While some changes in the model have occurred over time, the basic structure and function of our intensive care unit organizational infrastructure model has been remarkably stable and highly successful.