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Are Intensivists Safe?

2008; American College of Physicians; Volume: 148; Issue: 11 Linguagem: Inglês

10.7326/0003-4819-148-11-200806030-00010

1539-3704

Gordon D. Rubenfeld, Derek C. Angus,

Cardiac Arrest and Resuscitation

Editorials3 June 2008Are Intensivists Safe?Gordon D. Rubenfeld, MD, MSc and Derek C. Angus, MD, MPHGordon D. Rubenfeld, MD, MScFrom the University of Toronto, Toronto, Ontario MHN 3M5, Canada, and University of Pittsburgh School of Medicine, Pittsburgh, PA 15261. and Derek C. Angus, MD, MPHFrom the University of Toronto, Toronto, Ontario MHN 3M5, Canada, and University of Pittsburgh School of Medicine, Pittsburgh, PA 15261.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-11-200806030-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Intensivists have an identity problem. We do not perform unique procedures, such as coronary angioplasty or endoscopy. We used to take pride in our skills placing and interpreting data from pulmonary artery catheters, but this art is dying rapidly as the evidence mounts against its utility (1). We do not have an organ focus, as do neurologists or nephrologists. Many of us are internists, but others are pediatricians, anesthesiologists, neurologists, and surgeons. Despite this identity crisis, critical care medicine has not faded into obscurity but rather is enjoying a period of focused attention and popularity. Among the reasons are recent ...References1. Rubenfeld GD, McNamara-Aslin E, Rubinson L. The pulmonary artery catheter, 1967-2007: rest in peace? [Editorial]. JAMA. 2007;298:458-61. [PMID: 17652302] CrossrefMedlineGoogle Scholar2. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303-10. [PMID: 11445675] CrossrefMedlineGoogle Scholar3. Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al; Canadian Critical Care Trials Group. 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Intensivist physician staffing and the process of care in academic medical centres. Qual Saf Health Care. 2007;16:329-33. [PMID: 17913772] CrossrefMedlineGoogle Scholar20. Kollef MH, Ward S. The influence of access to a private attending physician on the withdrawal of life-sustaining therapies in the intensive care unit. Crit Care Med. 1999;27:2125-32. [PMID: 10548193] CrossrefMedlineGoogle Scholar21. Zimmerman JE, Alzola C, Von Rueden KT. The use of benchmarking to identify top performing critical care units: a preliminary assessment of their policies and practices. J Crit Care. 2003;18:76-86. [PMID: 12800117] CrossrefMedlineGoogle Scholar22. Pronovost PJ, Holzmueller CG, Clattenburg L, Berenholtz S, Martinez EA, Paz JR, et al. Team care: beyond open and closed intensive care units. Curr Opin Crit Care. 2006;12:604-8. [PMID: 17077695] CrossrefMedlineGoogle Scholar23. Kahn JM, Matthews FA, Angus DC, Barnato AE, Rubenfeld GD. Barriers to implementing the Leapfrog Group recommendations for intensivist physician staffing: a survey of intensive care unit directors. J Crit Care. 2007;22:97-103. [PMID: 17548019] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gordon D. Rubenfeld, MD, MSc; Derek C. Angus, MD, MPHAffiliations: From the University of Toronto, Toronto, Ontario MHN 3M5, Canada, and University of Pittsburgh School of Medicine, Pittsburgh, PA 15261.Potential Financial Conflicts of Interest: Drs. Rubenfeld and Angus are practicing intensivists.Corresponding Author: Gordon D. Rubenfeld, MD, MSc, Program in Trauma, Emergency, and Critical Care, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room D503, Toronto, Ontario M4N 3M5, Canada; e-mail, gordon.[email protected]ca.Current Author Addresses: Dr. Rubenfeld: Program in Trauma, Emergency, and Critical Care, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room D503, Toronto, Ontario M4N 3M5, Canada.Dr. Angus: University of Pittsburgh School of Medicine, 614 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit Mitchell M. Levy , John Rapoport , Stanley Lemeshow , Donald B. Chalfin , Gary Phillips , and Marion Danis What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit? William T. 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Grandeur et vicissitudesOrganizational Change in Critical Care: The Next Magic Bullet?Intensivist and Alternative Models of ICU StaffingMortality among Patients Admitted to Strained Intensive Care UnitsA Randomized Trial of Nighttime Physician Staffing in an Intensive Care UnitThe Evolving Model of Pediatric Critical Care Delivery in North AmericaStaffing in ICUsDoes Admission During Morning Rounds Increase the Mortality of Patients in the Medical ICU?Evolution of Critical Care Cardiology: Transformation of the Cardiovascular Intensive Care Unit and the Emerging Need for New Medical Staffing and Training ModelsTraining a hospitalist workforce to address the intensivist shortage in american hospitals: A position paper from the society of hospital medicine and the society of critical care medicineTwenty-four-Hour Intensivist Staffing in Teaching HospitalsThe Intensivist in the New Hospital EnvironmentMORE for multiple organ dysfunction syndrome: Multiple Organ REanimation, REgeneration, and REprogramming*ICU Staffing: The South American PerspectiveCharacteristics of intensive care units in Michigan: Not an open and closed caseHospitalists and intensivists: Partners in caring for the critically ill—The time has comeChanges in Intensive Care Unit Performance Measures Associated With Opening a Dedicated Thoracic Surgical Progressive Care UnitThe future of critical careUpdate in Critical Care 2008Physician Staffing Models and Patient Safety in the ICUDo Intensive Care Specialists Improve Patient Outcomes?Does Telemonitoring Of Patients—The eICU—Improve Intensive Care?Do Faculty Intensivists Have Better Outcomes When Caring for Patients Directly in a Closed ICU versus Consulting in an Open ICU?What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?William T. McGee, MD, MHAWhat Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?Constantine Manthous, MD and Yaw Amoateng-Adjepong, MD, PhDOrganization and Structure of the Cardiothoracic Intensive Care Unit 3 June 2008Volume 148, Issue 11Page: 877-879KeywordsAbdominal surgeryCritical careHealth careIntensive care unitsLungsMortalityPatientsSurgeonsSystematic reviewsTrauma surgery ePublished: 3 June 2008 Issue Published: 3 June 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...