Critical Care Organizations: Building and Integrating Academic Programs

Objective: Academic medical centers in North America are expanding their missions from the traditional triad of patient care, research, and education to include the broader issue of healthcare delivery improvement. In recent years, integrated Critical Care Organizations have developed within academic centers to better meet the challenges of this broadening mission. The goal of this article was to provide interested administrators and intensivists with the proper resources, lines of communication, and organizational approach to accomplish integration and Critical Care Organization formation effectively. Design: The Academic Critical Care Organization Building section workgroup of the taskforce established regular monthly conference calls to reach consensus on the development of a toolkit utilizing methods proven to advance the development of their own academic Critical Care Organizations. Relevant medical literature was reviewed by literature search. Materials from federal agencies and other national organizations were accessed through the Internet. Setting: The Society of Critical Care Medicine convened a taskforce entitled “Academic Leaders in Critical Care Medicine” on February 22, 2016 at the 45th Critical Care Congress using the expertise of successful leaders of advanced governance Critical Care Organizations in North America to develop a toolkit for advancing Critical Care Organizations. Measurements and Main Results: Key elements of an academic Critical Care Organization are outlined. The vital missions of multidisciplinary patient care, safety, and quality are linked to the research, education, and professional development missions that enhance the value of such organizations. Core features, benefits, barriers, and recommendations for integration of academic programs within Critical Care Organizations are described. Selected readings and resources to successfully implement the recommendations are provided. Communication with medical school and hospital leadership is discussed. Conclusions: We present the rationale for critical care programs to transition to integrated Critical Care Organizations within academic medical centers and provide recommendations and resources to facilitate this transition and foster Critical Care Organization effectiveness and future success.

[1]  C. Coopersmith,et al.  Critical Care Organizations: Business of Critical Care and Value/Performance Building* , 2018, Critical care medicine.

[2]  G. Phillips,et al.  Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients* , 2017, Critical care medicine.

[3]  Mark Nunnally,et al.  ICU Admission, Discharge, and Triage Guidelines: A Framework to Enhance Clinical Operations, Development of Institutional Policies, and Further Research , 2016, Critical care medicine.

[4]  L. Schoonhoven,et al.  Improving the governance of patient safety in emergency care: a systematic review of interventions , 2016, BMJ Open.

[5]  Natalie M. Pageler,et al.  Use of a Checklist and Clinical Decision Support Tool Reduces Laboratory Use and Improves Cost , 2016, Pediatrics.

[6]  Jane Noyes,et al.  Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative evidence-synthesis. , 2015, The Cochrane database of systematic reviews.

[7]  N. Halpern,et al.  Critical Care Organizations in Academic Medical Centers in North America: A Descriptive Report , 2015, Critical care medicine.

[8]  M. Pinsky,et al.  Faculty development for fellows: Developing and evaluating a broad-based career development course for critical care medicine trainees. , 2015, Journal of critical care.

[9]  The Formation, Elements of Success, and Challenges in Managing a Critical Care Program: Part II , 2015, Critical care medicine.

[10]  The formation, elements of success, and challenges in managing a critical care program: Part I. , 2015 .

[11]  David J Murphy,et al.  ICU director data: using data to assess value, inform local change, and relate to the external world. , 2015, Chest.

[12]  A. Cavalcanti A cluster randomized trial of a multifaceted quality improvement intervention in Brazilian intensive care units: study protocol , 2015, Implementation Science.

[13]  A. S. St. André The formation, elements of success, and challenges in managing a critical care program: Part I. , 2015, Critical care medicine.

[14]  Alberto Moreno-Conde,et al.  Clinical Decision Support using a Terminology Server to improve Patient Safety , 2015, MIE.

[15]  Henry E Fessler,et al.  Entrustable professional activities and curricular milestones for fellowship training in pulmonary and critical care medicine: report of a multisociety working group. , 2014, Chest.

[16]  Leonidas G. Koniaris,et al.  Electronic Medical Record: A Balancing Act of Patient Safety, Privacy and Health Care Delivery , 2014, The American journal of the medical sciences.

[17]  Grace C. Huang,et al.  The clinician-educator track: training internal medicine residents as clinician-educators. , 2014, Academic medicine : journal of the Association of American Medical Colleges.

[18]  F. Ognibene,et al.  Training Internists to Meet Critical Care Needs in the United States: A Consensus Statement from the Critical Care Societies Collaborative (CCSC)* , 2014, Critical care medicine.

[19]  M. Balas,et al.  Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility Bundle* , 2014, Critical care medicine.

[20]  Mayur B. Patel,et al.  An International Career Development Survey of Critical Care Practitioners* , 2014, Critical care medicine.

[21]  H. Gershengorn,et al.  Management strategies to effect change in intensive care units: lessons from the world of business. Part III. Effectively effecting and sustaining change. , 2014, Annals of the American Thoracic Society.

[22]  H. Gershengorn,et al.  Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies. , 2014, Annals of the American Thoracic Society.

[23]  H. Gershengorn,et al.  Management strategies to effect change in intensive care units: lessons from the world of business. Part I. Targeting quality improvement initiatives. , 2014, Annals of the American Thoracic Society.

[24]  J. Marshall,et al.  Critical care trainees' career goals and needs: A Canadian survey. , 2014, Canadian respiratory journal.

[25]  S. Straus,et al.  Characteristics of Successful and Failed Mentoring Relationships: A Qualitative Study Across Two Academic Health Centers , 2013, Academic medicine : journal of the Association of American Medical Colleges.

[26]  Michael M. Vigoda,et al.  Future of electronic health records: implications for decision support. , 2012, The Mount Sinai journal of medicine, New York.

[27]  Charles G Prober,et al.  Lecture halls without lectures--a proposal for medical education. , 2012, The New England journal of medicine.

[28]  R. Lofgren,et al.  Commentary: Institutes versus traditional administrative academic health center structures. , 2012, Academic medicine : journal of the Association of American Medical Colleges.

[29]  J. Kastor Point-counterpoint: The Cleveland Clinic institute system is the right structure for academic health centers in the 21st century. , 2012, Academic medicine : journal of the Association of American Medical Colleges.

[30]  D. Cosgrove,et al.  Commentary: Change we must: putting patients first with the institute model of academic health center organization. , 2012, Academic medicine : journal of the Association of American Medical Colleges.

[31]  J. Kastor Point-counterpoint: The traditional departmental model is the right structure for academic health centers in the 21st century. , 2012, Academic medicine : journal of the Association of American Medical Colleges.

[32]  C. Deutschman,et al.  Multisociety Task Force for Critical Care Research: Key issues and recommendations* , 2012, Critical care medicine.

[33]  C. Deutschman,et al.  Multisociety task force for critical care research: key issues and recommendations. , 2012, American journal of respiratory and critical care medicine.

[34]  K. Schulman,et al.  Training the next generation of physician-executives: an innovative residency pathway in management and leadership. , 2011, Academic medicine : journal of the Association of American Medical Colleges.

[35]  Peggy Soule Odegard,et al.  Interprofessional collaboration: three best practice models of interprofessional education , 2011, Medical education online.

[36]  K. D. Young,et al.  An assessment of the faculty development needs of junior clinical faculty in emergency medicine. , 2008, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[37]  Carey L. Thaldorf,et al.  Integration of health care organizations: using the power strategies of horizontal and vertical integration in public and private health systems. , 2007, The health care manager.

[38]  R. Saura,et al.  Quality indicators in critically ill patients , 2006, Critical Care.

[39]  P. Pronovost,et al.  Intensive care unit quality improvement: A “how-to” guide for the interdisciplinary team* , 2006, Critical care medicine.

[40]  D. Ingbar,et al.  Academic and career development of pulmonary and critical care physician-scientists. , 2006, American journal of respiratory and critical care medicine.

[41]  J. Grossman,et al.  Building a Better Delivery System: A New Engineering/Health Care Partnership , 2005 .

[42]  P. Safar Critical care medicine‐quo vadis? , 1974, Critical care medicine.