Growing interest in reducing costs for patients requiring long-term mechanical ventilation has led to development of different care delivery models. This article describes the development and implementation a respiratory care process model focusing on best practices and improvement in care, including early mobility. To implement the care process model, the authors had to make significant change...

Experts and agencies increasingly advocate tight glycemic control (TGC) using intensive intravenous insulin therapy in critically ill patients. Questions remain about the "best" glucose goal, the universal benefit of TGC in the heterogeneous adult intensive care unit (ICU) population, and concerns about the underrecognized incidence of hypoglycemia and its neuropsychological sequelae. TGC is ti...

In an effort to improve patient safety, researchers at the Johns Hopkins University designed and implemented a comprehensive Web-based Intensive Care Unit Safety Reporting System (ICUSRS). The ICUSRS collects data about adverse events and near misses from all staff in the ICU. This report reflects data on 854 reports from 18 diverse ICUs across the United States. Reporting is voluntary, and dat...

This paper reports the evaluation of a Recursive-Diagnostic Framework (RDF) based paper prototype for a clinical information system in the intensive care unit (ICU). Based on an observation of the reliability and validity of RDF concepts when applied to real-world data, it was hypothesised that an RDF-based information design might facilitate more efficient information processing by ICU medical...

Digital information flow within the intensive care unit (ICU) continues to grow, with advances in technology and computational biology. Recent developments in the integration and archiving of these data have resulted in new opportunities for data analysis and clinical feedback. New problems associated with ICU databases have also arisen. ICU data are high-dimensional, often sparse, asynchronous...

OBJECTIVE There is a growing literature on the relationship between teamwork and patient outcomes in intensive care, providing new insights into the skills required for effective team performance. The purpose of this review is to consolidate the most robust findings from this research into an intensive care unit (ICU) team performance framework. DATA SOURCES Studies investigating teamwork wit...

Endotracheal intubation in the ICU is a high-risk procedure, resulting in significant morbidity and mortality. Up to 40% of cases are associated with marked hypoxemia or hypotension. The ICU patient is physiologically very different from the usual patient who undergoes intubation in the operating room, and different intubation techniques should be considered. The common operating room practice ...

BACKGROUND Robotic telepresence has been used for outsourcing of healthcare services for more than a decade; however, its use within an academic medical department is not yet widespread. Intensive care unit (ICU) robots can be used to increase access to off-site supervising physicians and other specialists, reducing possible wait time for difficult admissions and procedures. OBJECTIVE To stud...

Clinical handover is a process of transferring a patient's clinical information from one team to another. Poor quality of handover of critically ill patients associates with misunderstanding, delay in treatment, and adverse outcomes. Therefore, a high quality and standardized information flow process and documentation are definitely crucial. We have developed a web-based platform for generating...