| Team Approach to Critical Care Makes a Difference for Patients and Families Tri-City Voice, May 14, 2008 In a
hospital’s intensive care unit (ICU),
trained doctors, nurses and other
experts provide specialized care for
patients with life-threatening illnesses
or injuries. Each year, 5 million
Americans are admitted to ICUs,
receiving treatment for serious
conditions ranging from respiratory or
heart failure to body-wide infection
(sepsis) to care after surgery. As our
population ages, the need for this
specialized field of medicine, also
called Critical Care, continues to grow.
"Many
ICU patients have sustained, or are at
risk of suffering the failure of one or
more vital functions, systems or
organs," explains Carmencita Agcaoili,
M.D., a board certified Critical Care
specialist at Washington Hospital.
"Consequently, they require intensive
care and monitoring to reverse their
near fatal conditions and temporarily
support them while they recover from the
underlying disease or injury."
May
is National Critical Care Awareness and
Recognition Month – a good time to learn
more about Critical Care, what Critical
Care practitioners do, and how they
function in the ICU setting.
On
any given day in the U.S., about 6,000
hospital ICUs care for a total of 55,000
critically ill patients. A stay in this
highly specialized unit can last from
hours to days or even weeks.
Traditionally, care in the ICU has been
managed by the patient’s attending
physician. Now, studies show a team
approach to ICU care management results
in markedly improved patient outcomes by
shortening the length of stay, giving
patients and families a better
experience, and saving more lives.
The
Society of Critical Care Medicine
reports more than 160,000 lives could be
saved annually if care in the ICU were
delivered by an intensivist-directed
multi-professional team. An intensivist
is a physician who is board certified in
a medical specialty, such as internal
medicine, surgery, anesthesiology or
pediatrics. Intensivists have also
received special education, training and
subspecialty certification in Critical
Care.
In
the multi-professional team care model,
the intensivist leads an integrated
group of experts made up of any of the
following individuals, depending on the
patient’s condition: physicians; nurses;
pharmacists; respiratory therapists;
nutritionists; speech, physical and
occupational therapists; clergy; social
workers and case managers. Any medical
professional who focuses on
patient-centered care could be a member
of the team.
Critical Care at Washington Hospital
Last January, Washington
Hospital began developing an Intensivist
Program for patients in its ICU. Led by
Dr. Agcaoili and working actively with
admitting physicians, the
multidisciplinary team visits patients
once or twice a day to ensure that safe,
high quality Critical Care is provided
from a range of medical perspectives.
The hospital plans to expand the program
in the future to include additional
intensivists and ‘round-the-clock
availability.
"Although we started the team approach
only two months ago, we already see
progress being made," reports Dr. Agcaoili. "We look forward to the day
when the program is in full swing."
A
stay in the ICU is often a stressful,
highly emotional time for patients, as
well as for their family and friends. To
help relieve stress and confusion, the intensivist-directed team communicates
regularly with patients and families,
helping them understand the problem and
the plan of care.
"Our
philosophy is to coordinate services and
offer compassionate, individualized care
for both patients and families," adds
Dr. Agcaoili. "We find that responding
to their unmet needs helps to improve
the quality and outcomes."
In
Washington’s ICU, families also benefit
from the hospital’s Family Care
Assistance Program, which helps patients
and families understand the illnesses or
conditions treated in the intensive care
setting and the work of Critical Care
practitioners. Additional information is
available through Krames Online, an
up-to-date health education resource
with more than 4,000 topics available 24
hours a day.
Advance directive advised
To help people prepare for
a medical crisis that could bring them
to the ICU – or any other medical unit
of the hospital, Washington urges all
adults over age 18 to complete an
advance directive. The directive is a
legal document that tells medical staff
what kind of care an individual would
want if he or she becomes unable to make
or communicate their own medical
decisions. Patients receive information
about advance directives when they are
admitted to Washington Hospital, but the
optimal time to complete the document
and have it witnessed is before a
medical need arises.
For
more information about advance
directives, visit the California
Hospital Association (CHA) website at
www.calhospital.org.
The CHA Advance Health Care Directive is
available in English and Spanish. For
more information about Critical Care, go
online to
www.myicucare.org,
on the website of the Society of
Critical Care Medicine.
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