TABLE 1.
Workplace Challenges for the ICU Team | ||
---|---|---|
Complex Patients | Complex Environment | Complex Therapies |
Complex chronic comorbidities | Increasing technology | Closed-loop titration systems |
Chronic invasive devices | Expanding documentation | Inflammatory response manipulation |
Out-of-hospital monitoring | Risk of information overload | Stress response modulation |
Compromised immune status | Challenges of continuity | Maintaining patient participation |
Bimodal extended life span | Danger of alarm fatigue | Monitoring expected trajectory |
Increased illness severity | Ensuring adequate handoff | New therapies to minimize postintensive care syndrome |
Telehealth from the ICU | Addressing patient, family, and clinicians | |
Diurnal rhythm | ||
Workforce shortages | ||
Rising cost of healthcare | ||
Intercalated Elements of a Learning Healthcare System | ||
Patient Care | Shared Education | Clinical Research |
Multidisciplinary | Just-in-time simulation | Links to national databases |
Patient- and family-centered | Frequent debriefing sessions | Continuous QI |
Evidence-based | Joint case reviews | All patients potential research subjects |
Ultrasonography proficiency | Burnout risk awareness | Dashboards for QI activity |
Holistic and humanistic | Monitoring of provider competency | |
Characteristics of the ICU Team of the Future | ||
Individual | Team | Administration |
Enjoys out-of-box challenges | Promotes situational awareness | Provides adequate staffing |
Nurtures resilience | Encourages team members | Supports multifaceted QI |
Engages in nonwork renewal | Encourages family as part of ICU team | Seeks suggestions for improvement |
Values humanism in care | Avoids wasteful practices | Maintains awareness of front line |
Practices personal wellness | Practices cross-training | Monitors staff turnover |
Has ICU personality | Has multiprofessional and collaborative members | Facilitates/funds national networking |
Provides patient and family support and comfort | Offers lifestyle improvement perks |
QI = quality improvement.