Special FeatureThe Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine☆,☆☆
Section snippets
Background
“It's an opaque term, intensive care. Specialists in the field prefer to call what they do critical care, but that still doesn't exactly clarify matters.”
― Atul Gawande: The Checklist Manifesto.
The presence of a well-trained intensive care unit (ICU) specialist has been shown to improve outcomes in ICUs worldwide [1], [2], [3]. Nevertheless, the role an ICU specialist portrays has to be clearly defined. Training programs in intensive care medicine (ICM) are becoming established in some
Objectives and methods
The World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) represents more than 80 intensive and critical care medicine societies and has set up a task force to define an ICU specialist.
The WFSICCM communicated with member societies to designate experts from the field in their country to contribute to the task force. This document is the culmination of discussions occurring through e-mail, video conferences, and a satellite meeting during the 2015 World Congress of the
Follow-up of patients after discharge from ICU
Several patients have long-term problems after discharge from ICU [39]. This so-called post–intensive care syndrome adversely affects recovery of physical strength and activity, reduces quality of life, adds to the burden for families, and increases costs. Psychological sequelae such as anxiety, depression, and posttraumatic stress disorder in patients can occur in up to 50% survivors of critical illness as well as in their family members. Follow-up clinics have been developed to minimize
Conclusion
The role of intensivist in the current practice of modern acute care is of paramount importance. Patient care needs to be at the center of all decisions and actions. The intensivist should promote the culture of competent, compassionate, and cost-effective care of the critically ill. The intensivist must demonstrate ethical values, expertise, and professionalism in day-to-day work. The intensivist should evolve a work culture that promotes collaborative relationships with members of the health
Author contributions
Task force planning: Pravin Amin (India), Djillali Annane (France), Lluís Blanch, (Spain), Guillermo Castorena (Mexico), Bin Du (China), Edgar Jimenez (USA), Younsuck Koh (Korea), John Marshall (Canada), John Myburgh (Australia), Masaji Nishimura (Japan), Paolo Pelosi (Italy), Álvaro Réa-Neto (Brazil), Arzu Topeli (Turkey), Sebastian Ugarte (Chile), Jean-Louis Vincent (Belgium), Janice Zimmerman (USA)
Critical revision of the manuscript for important intellectual content: Defne Altintas
References (41)
- et al.
Effect on ICU mortality of a full-time critical care specialist
Chest
(1989) - et al.
Intensivist-to-bed ratio: association with outcomes in the medical ICU
Chest
(2005) - et al.
Benchmark data from more than 240,000 adults that reflect the current practice of critical care in the United States
Chest
(2011) - et al.
Nighttime intensivist staffing, mortality, and limits on life support: a retrospective cohort study
Chest
(2015) - et al.
The critical care medicine crisis: a call for federal action: a white paper from the critical care professional societies
Chest
(2004) - et al.
Impact of critical care physician staffing on patients with septic shock in a university hospital medical intensive care unit
JAMA
(1988) - et al.
On-site physician staffing in a community hospital intensive care unit. Impact on test and procedure use and on patient outcome
JAMA
(1984) Intensive care unit physician staffing: seven days a week, 24 hours a day
Crit Care Med
(2006)- et al.
The effect of multidisciplinary care teams on intensive care unit mortality
Arch Intern Med
(2010) - et al.
Potential reduction in mortality rates using an intensivist model to manage intensive care units
Eff Clin Pract
(2000)
Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review
JAMA
Association between critical care physician management and patient mortality in the intensive care unit
Ann Intern Med
Variation in intensive care unit outcomes: a search for the evidence on organizational factors
Curr Opin Crit Care
Do intensivist staffing patterns influence hospital mortality following ICU admission? A systematic review and meta-analyses
Crit Care Med
Variation in critical care services across North America and Western Europe
Crit Care Med
Impact of telemedicine intensive care unit coverage on patient outcomes: a systematic review and meta-analysis
Arch Intern Med
The use of nonphysician providers in adult intensive care units
Am J Respir Crit Care Med
Evaluating tele-ICU cost—an imperfect science
Crit Care Med
An international survey of training in adult intensive care medicine
Intensive Care Med
Models for intensive care training. A European perspective
Am J Respir Crit Care Med
Cited by (32)
Carbon nanomaterials-based electrochemical aptasensor for point-of-care diagnostics of cancer biomarkers
2023, Materials Today ChemistryColombian consensus on quality in intensive care: task force of the Colombian Association of Critical Medicine and Intensive Care (AMCI®)
2023, Acta Colombiana de Cuidado IntensivoCriteria deemed important by ICU patients when designating a reference person
2022, Journal of Intensive MedicineCitation Excerpt :A family centered approach[8] emphasizes these criteria for selecting a surrogate, not least because the healthcare team will have to discuss various ethical questions with that person during the patient's ICU stay. Such questions may include but are not limited to end-of-life issues, the risk–benefit ratio of ICU care for the patient in terms of future quality of life[9,10] the level of therapeutic engagement, and the development of a healthcare plan. Before their admission to ICUs in France, patients rarely convey their wishes and desires regarding healthcare or end-of-life issues to their family members.
An examination of cardiovascular intensive care unit mortality based on admission day and time
2021, Heart and LungCitation Excerpt :This data suggests that a partial cardiac intensivist model deployed in an open CICU (without weekend & night cardiac intensivist or multidisciplinary ICU rounds) had no difference in mortality. Our data is consistent with the general ICU literature, professional organization statements, and expert opinion describing intensivist-led, closed-model ICUs having lower ICU mortality without an increase in resource utilization.8,12,24 –26 Other explanations for lack of mortality benefit include a smaller sample size (January 2018 to June 2019) and that no analysis of cardiac intensivist-only admissions were performed.
The pandemic in French intensive care units—Author's response
2021, The Lancet Regional Health - EuropePatient and family engagement in the ICU: Report from the task force of the World Federation of Societies of Intensive and Critical Care Medicine
2018, Journal of Critical CareCitation Excerpt :The degree to which specific types of patient and family focused practices are being implemented worldwide is not known. As part of a series of Task Forces developed by the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) [6-21], an international organization with over 85 societies in over 75 countries of the world, a survey was conducted to assess the types of patient and family engagement practices being implemented worldwide. The purpose of this international cross-sectional survey was to collect information on patient and family engagement initiatives in the ICU, as well as barriers and strategies to implementation.
- ☆
Financial support: None.
- ☆☆
Conflict of interest disclosures related to this manuscript: None declared.