Elsevier

Journal of Critical Care

Volume 35, October 2016, Pages 223-228
Journal of Critical Care

Special Feature
The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine,☆☆

https://doi.org/10.1016/j.jcrc.2016.06.001Get rights and content

Abstract

The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. However, many ICUs across the world function as “open ICUs,” in which patients may be admitted under a primary physician who has not been trained in critical care medicine. Although the concept of the ICU has gained widespread acceptance amongst medical professionals, hospital administrators and the general public; recognition and the need for doctors specializing in intensive care medicine has lagged behind. The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist.

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

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    Conflict of interest disclosures related to this manuscript: None declared.

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