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Critical Care: Critical Care - ICU Management |

Intermediate Care to Intensive Care Triage: A Quality Improvement Project

Pranav Chandrashekar, MBBS; Ali Abdel-Halim; David Hager, MD
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Johns Hopkins Hospital, Baltimore, MD


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


Chest. 2016;150(4_S):213A. doi:10.1016/j.chest.2016.08.226
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Extract

SESSION TITLE: Critical Care - ICU Management

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Intermediate care units (IMCUs) were created to accommodate patients whose care needs exceed what is feasible on a general ward, but do not require intensive care. However, some patients triaged to intermediate care may deteriorate and require intensive care. Like many teaching hospitals, the decision to escalate care at Johns Hopkins Hospital is often made by resident physicians (PGY2 or PGY3). This responsibility can cause stress due to uncertainty and can lead to delays in Intensive Care Unit (ICU) admission. Discussion of triage decisions, and sharing this responsibility with supervising physicians is encouraged, but does not always take place. We conducted a quality improvement (QI) project to (1) facilitate communication between resident and supervising physicians, and (2) expedite transfer of appropriate patients from our medical IMCU to the medical ICU.

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