PURPOSE: The intensivist-led model of care has been shown to increase patient safety, raise the standard of care delivered to patients and increase the satisfaction of the allied health care professionals. This model of care was introduced the Toronto East General Hospital, a 500 bed community hospital, in an attempt to improve patient care in the ICU.
METHODS: A core number of ICU physicians were hired to lead an aggressive educational campaign throughout the organization. The creation of a dedicated multidisciplinary team of health care professionals led by the ICU physician took over the care of all patients admitted to the ICU. We used guidelines and protocols published by the Society of Critical Medicine, American College of Chest Physicians, Institute for Healthcare Improvement and the Surviving Sepsis Campaign. We measured patient outcomes, resource utilization, length of stay, ventilator days and worker satisfaction. Organizational surveys were also performed to gauge the organizational perspective on quality of care.
RESULTS: We compared data collected from July 2004 to August 2006 and compared the data to the years prior to the change in the model of delivery of care. We measured a 50% reduction in the ventilator days in medical ICU admissions and 20% decrease in the length of stay in surgical patients. We measured a 74% reduction in the use of Swan-Ganz catheters and a 66% reduction in the use of TPN. We noted a relative increase in the accessibility of the the ICU and only 0.5% cancellation rate of elective surgery cases. Surveys of the allied health care professionals shows a dramatic increase in the worker satisfaction with their work environment and their perception of the patient care.
CONCLUSION: The new model of delivery of care, led by the intensivist, improves the delivery of care, increases patient safety, increases worker satisfaction and improves hospital resource allocation.
CLINICAL IMPLICATIONS: The creation of the intensivist-led model of care in the large community hospital will lead to better patient care and better staff recruitment and retention.
DISCLOSURE: Carmine Simone, No Financial Disclosure Information; No Product/Research Disclosure Information