ICU Volume 14 - Issue 1 - Spring 2014

Is there such a thing as a perfect ICU? Organisation and design of the ICU has evolved exponentially since the first units delivering intensive care were set up in the 1950s. Organisation and design of the perfect ICU involves many factors – architecture, equipment and technology, staffing, patients and families. In our cover story this issue we include two articles, which suggest there is much still to b...

Severe Sepsis: Are Outcomes Better if Hospitals Treat a High Volume of Patients? A study from the Boston University School of Medicine, published recently in the American Journal of Respiratory and Critical Care Medicine, looked at the associations between hospital sepsis caseload and outcomes, and found that academic hospitals with higher severe sepsis case volume have lower severe sepsis hospital morta...

Professor Rinaldo Bellomo, Australia Rinaldo Bellomo is the Director of Intensive Care Research at Austin Health in Melbourne; Professorial Fellow, Faculty of Medicine, University of Melbourne, Australia; Honorary Professor, Faculty of Medicine, Monash University, Melbourne Australia; Honorary Professorial Fellow, Faculty of Medicine, The University of Sydney, Australia; Honorary Professorial Fello...

Authors Alan D. Ravitz, PE1 Peter J. Pronovost, MD, PhD2-4 Adam Sapirstein, MD2,3 Johns Hopkins Applied Physics Laboratory, Laurel, USA.1; Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, USA2; School of Medicine, The Johns Hopkins University, Baltimore, USA3; Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, USA4 asapirs1@jhmi....

Authors Peter J. Pronovost, MD, PhD, FCCM1-3 Clifford S. Deutschman, MS, MD, FCCM4,9 Kathryn E. Roberts, MSN, RN, CNS5 Alan D. Ravitz, PE6 Bradford D. Winters, PhD, MD, FCCM1,2 Jo M. Leslie, MBA1 Douglas S. Solomon, PhD, MPH7 George W. Bo-Linn, MD, MPH, FACP8 Adam Sapirstein, MD1,2 for the Johns Hopkins Armstrong Institute ICU Innovation Consortium Armstrong Institute for Patient Saf...

COMPANY NAMES American Association of Critical Care Nurses, Aliso Viejo, CA Kathryn Roberts Maureen Seckel Association for the Advancement of Medical Instrumentation, Arlington, VA Mary Logan Leah C. Lough B-Line Medical, LLC, Washington, D.C....

Your Role: Your role is to be a neutral observer, with fresh eyes, of what you see during your ICU visit. We would like you to pay particular attention to the PEOPLE (patients, staff and family visitors): how they work, how they flow, how they affect the care and safety of patients. You may interview a staff member and/or patients or family members. Keep...

Your Role: Your role is to be a neutral observer, with fresh eyes, of what you see during your ICU visit. We would like you to pay particular attention to the TECHNOLOGY AND SPACE of the ICU and how they help or hinder the care and safety of patients. If you have questions, please check with your guide or host before approaching staff members. Keep your q...

Your Role: Your role is to be a neutral observer, with fresh eyes, of what you see during your ICU visit. We would like you to pay particular attention to the WORK PROCESSES: how patients, staff and family visitors interact and flow through the ICU, and how they affect the care and safety of patients. If you have questions, please check with your guide or...

Authors Federico Longhini, MD Department of Translational Medicine Eastern Piedmont University “A. Avogadro” Novara, Italy Gianmaria Cammarota, MD, PhD Department of Anaesthesia and Intensive Care “Maggiore Della Carità” Hospital Novara, Italy Rosanna Vaschetto, MD, PhD Department of Anaesthesia and Intensive Care “Maggiore Della Carità” Hospital Novara, Italy Paolo Navales...

Author James S. Krinsley, MD, FCCM Director of Critical Care, Stamford Hospital Stamford, Connecticut Clinical Professor of Medicine, Columbia University College of Physicians and Surgeons New York, USA [email protected] Introduction Glycaemic control of the critically ill has been a topic of considerable interest in the critical care community since the publication of a single-centre rando...

Authors Alain Combes, MD Medical-Surgical Intensive Care Unit iCAN, Institute of Cardiometabolism and Nutrition Hôpital de la Pitié–Salpêtrière, Assistance Publique–Hôpitaux de Paris Université Pierre et Marie Curie Paris, France [email protected] Guillaume Lebreton, MD Cardiac Surgery Department iCAN, Institute of Cardiometabolism and Nutrition Hôpital de la Pitié–Salp�...

Author Anthony McLean, MBChB, BSc(Hons), MD, FRACP, FCICM, FCSANZ Clinical Professor, Department of Intensive Care Medicine, Nepean Hospital, University of Sydney, Sydney, Australia [email protected] Echocardiography is often an essential component in the management of a critically ill patient and setting up a service of acceptable quality requires attention to efficiency, sustainab...

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Authors Sarah Clarke Director and Lead Nurse, Cheshire & Mersey Critical Care Network, UK Dr Gary Masterson Medical Lead Cheshire & Mersey Critical Care Network, Consultant in Critical Care Medicine Royal Liverpool University Hospital, Liverpool, UK [email protected] A Network Lean Methodology Approach improves the cost-effectiveness of, and reduces the wastage in,...

Dr. Jerry Nolan was co-editor of the European Resuscitation Council Guidelines for Resuscitation 2010. He is Consultant in Anaesthesia and Intensive Care Medicine at the Royal United Hospital, Bath in the UK. In addition he serves as Vice Chairman of the European Resuscitation Council, a Member of the Executive Committee of the Resuscitation Council (UK), Chairman of the Steering Group of the National Car...

Author Ross Freebairn, FCICM Consultant, Intensive Care Services & Clinical Director, Acute Services Hawke's Bay Hospital, Hastings, New Zealand Adjunct Associate Professor, Department of Anaesthesia & Intensive Care Chinese University of Hong Kong, President, College of Intensive Care Medicine, Melbourne, Australia [email protected] The College of Intensive Care Medic...

Authors David Pilcher, MBBS FCICM Chair Australian and New Zealand, Intensive Care Society Centre for Outcomes and Resource Evaluation, Carlton Victoria, Australia, Intensivist Department of Intensive Care, The Alfred Hospital, Melbourne Victoria, Australia Adjunct Associate Clinical Professor Australian and New Zealand, Intensive Care Research Centre Department of Epidemiology & Pre...