0
Clinical Commentary: ICU CARE MODELS |

Changing the Work Environment in ICUs to Achieve Patient-Focused Care*: The Time Has Come

Kathleen McCauley, RN, BC, PhD; Richard S. Irwin, MD, FCCP
Author and Funding Information

*From the University of Pennsylvania School of Nursing and Hospital (Dr. McCauley), Philadelphia, PA; and the University of Massachusetts and UMass Memorial Medical Center (Dr. Irwin), Worcester, MA.

Correspondence to: Kathleen McCauley, RN, BC, PhD, University of Pennsylvania, School of Nursing and Hospital, 31 South Wyoming Ave, Ardmore, PA 19003-1230; e-mail: kmccaule@nursing.upenn.edu



Chest. 2006;130(5):1571-1578. doi:10.1378/chest.130.5.1571
Text Size: A A A
Published online

The American Association of Critical-Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians (ACCP) Patient-Focused Care Project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, patient-focused care can thrive. Healthy work environments are so influential that failure to address the issue would result in deleterious effects for every aspect of acute care and critical care practice. Skilled communication and true collaboration are crucial for transforming work environments. The ACCP project on patient-focused care was born out of a realization that medicine as currently practiced is too fragmented, too focused on turf battles that hinder communication, and too divorced from a real understanding of what patients expect and need from their health-care providers. Communication as well as continuity and concordance with the patients’ wishes are the foundational premises of care that is patient-focused and safe. Some individuals may achieve some level of genuine patient-focused care even when they practice in a toxic work environment because they are gifted communicators who embrace true collaboration. At best, those efforts will most likely be hit-or-miss, and such heroism will be impossible to sustain if the environment is not transformed into a model that reflects the standards and initiatives set out by the AACN and the ACCP. Other innovative models of care delivery remain unreported. The successes and failures of these models should be shared with the professional community.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Family Member Presence During Cardiopulmonary Resuscitation*: A Survey of US and International Critical Care Professionals
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543