Education, Research, and Quality Improvement: Education and Quality Improvement |

Quantification of Critical Care Medicine: An Interim Report FREE TO VIEW

Yashaswini Yeragunta, MD; Stefan Leichtle, MD; Joleen Aguon, MD; Renli Qiao, MD
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University of Southern California, Los Angeles, CA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A235. doi:10.1016/j.chest.2016.02.244
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SESSION TITLE: Education and Quality Improvement

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Despite an increasing demand, the shortage in Critical Care workforce is worsening. Meanwhile, while fellowships in Pulmonary and Critical Care Medicine (PCCM) are expanding, other Critical Care Medicine (CCM) programs are staggering. No good explanation exists for this contradictory trend, although its understanding may lead to a solution of the shortage. The fundamental difference between PCCM and CCM lies in the residency training of respective candidates. Therefore we tested the hypothesis that the nature of CCM determines its attractiveness to future candidates.

METHODS: A questionnaire was administered among fellows in the medical and surgical ICUs of two tertiary teaching hospitals, one a private and the other a public institution. ICU activities were categorized into conventional CCM and respiratory, medical, and surgical interventions. The survey collected daily activities performed on all patients in the ICUs for seven consecutive days. Data from a single day is reported here.

RESULTS: 16 patients (25% female) with median age 54 years were located in the medical ICUs. 100% had two or more medical comorbidities. The most common diagnoses for admission were sepsis (37.5%) and acute respiratory distress (18.8%). The 185 daily activities performed in these patients were divided into conventional CCM (21%), respiratory (4%), medical (77%), and surgical (1%) interventions. In the surgical/trauma ICUs there were 27 patients (20% female) with median age 44 years. The most common reasons for admission were trauma (50%) and postoperative recovery (40%). The 152 daily activities performed were: conventional CCM (21%), respiratory (29%), medical (33%), and surgical (18%) interventions. Thus, medical and respiratory interventions represented the majority of daily tasks in medical (81%) and surgical (62%) ICUs.

CONCLUSIONS: This is the first quantification of daily ICU tasks. It delineates the central role of medical and respiratory interventions in both medical and surgical ICUs.

CLINICAL IMPLICATIONS: The data indicates that majority of the ICU daily practices rely on medical/respiratory interventions. This is reflective as to why PCCM, with applicants all having completed residency training in internal medicine, is popular.

DISCLOSURE: The following authors have nothing to disclose: Yashaswini Yeragunta, Stefan Leichtle, Joleen Aguon, Renli Qiao

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