Critical Care Administration: A Comprehensive Clinical Guide

✍ Scribed by Jorge Hidalgo (editor), Javier Pérez-Fernández (editor), Gloria Rodríguez-Vega (editor)

• Publisher: Springer
• Year: 2020
• Tongue: English
• Leaves: 284
• Category: Library

✦ Synopsis

This book provides a state-of-the-art overview on critical care administration. The text reviews important aspects and considerations involved in developing an efficient, cost-effective critical care program, while maintaining a safe and high-quality work environment. Major topics covered include different models of critical care services, planning and budgeting, administration support, staffing models, tele/smart ICU, protocols and guidelines, and disaster preparedness and management.

Written by experts in the field, Critical Care Administration: A Comprehensive Clinical Guide is a practical, handy resource for critical care professionals involved in the administration and management of ICUs.

✦ Table of Contents

Foreword
Preface
Acknowledgments
Contents
Contributors
Chapter 1: Critical Care Services: Scope of Practice
Introduction
ICU Organizational Models
Definitions
Clinical Outcomes Associated with Different ICU Organizational Models
Outcomes Related to 24/7 and Night Coverage by ICU Physicians
General and Specialized ICUs
Critical Care Services Outside the ICU
Summary
ICU Rounds
The Composition of the Multidisciplinary Team
The Structure and Organization of ICU Rounds
Summary
Conclusion
References
Chapter 2: Planning and Budgeting
Introduction
Strategic Planning
A Strategic Assessment
Formulating Objectives
Making Strategic Choices
Budgeting
The Budgeting Context for Intensive Care
Characteristics of Intensive Care Budgeting
Types of Budgets
Revenue
Operating Expenses
Case Mix Index (CMI)
Intensive Care Costing Methodology and Efficiency
Population Mix/Payers Mix
Understanding the Need for Intensive Care Beds
Outcomes with Intensive Care
Decreasing the Cost of Care
Return on Investment
Tele-ICU as a Key Element of Achieving ROI
Cost-Effectiveness Analysis
Training for Staff, Fellows, and Residents
Fellowship Training Requirements
Interprofessional Education (IPE) Approach
Professional Development Program
References
Chapter 3: Setting the Goals
Introduction
Medical Staff Needs
The ICU: What Type of Unit and Who Staffs It?
Staffing (Continued) and Organization
Outreach Services
Institutional Needs
References
Chapter 4: Administration Support
Introduction
ICU Models of Care
Functional Considerations
Staffing Considerations
24-Hour Intensivist Staffing
Other Considerations
Critical Care Transport
The ICU as a High Reliability Organization
Conclusion
References
Chapter 5: Quality Indicators: The Use of Metrics in Critical Care Medicine
Value in Healthcare
Framework for Assessing Quality
Essential Attributes of Quality Metrics
Setting Your Quality Program Up for Success
Examples of Quality Metrics in Critical Care
Potential Pitfalls to Avoid
Conclusions
References
Chapter 6: Internal Financial Audits in the ICU
Introduction and Overview
The Internal ICU Financial Audit
Summary
References
Additional Reading
Chapter 7: Models of Staffing
Overview
Intensivist Staffing
ICU Organization
Critical Care Society Recommendations
Nurse Staffing
Nurse Practitioners and Physician Assistants
Resident/Fellow Supervision
Hospitalists
Telemedicine
Summary
References
Chapter 8: Tele-ICU
Introduction
Models of Tele-ICU
Centralized Model
Decentralized Model
Hybrid Model
Staffing for Tele-ICU
Financial Considerations
Barriers to Implementation
Outcomes from Utilization of Tele-ICU
Provider-Centered Outcomes
Patient-Centered Outcomes
System-Centered Outcomes
Conclusion
References
Chapter 9: Digital Transformation: The Smart ICU
The Cultural Factor
The Elements of the Digital Transformation
Benefits of the Digital Transformation
Improving Patient Care
Facilitating Administrative Workload
Resource Utilization
Expansion of Knowledge
Communication
Telemedicine: Tele-ICU
Smart ICU
The “Techno” Problem
Systems’ Interoperability
Why Do We Need Smart ICU?
The Components of Smart ICU
Artificial Intelligence (AI)
Conclusions
References
Chapter 10: Protocols, Policies, and Procedures: Tools for Quality Improvement in Critical Care
Introduction
Tools to Implement ICU Policies and Procedures
Overview of Policy Development and Establishing a Quality Improvement Committee and Programme
Implementation of Policies
Measurement of Performance
Compliance with Physician Reporting
Conclusion
References
Chapter 11: ICU Design
The Patient Room
The Corridor Outside of Patient Rooms
Unit Configuration
Non-clinical Space
Final Thoughts on ICU Design
References
Chapter 12: Disaster Preparedness and Management
Disaster Fundamentals
Staff and Leadership Preparation
Preparation for Care
Preparation for Supervision
Preparation for Leadership
Planning
All-Hazard Approach
Key Local Events Including Weather
Physical Plant Considerations
Charting and Documentation
Communication
Water, Linens, Food, and Supply Chain Maintenance
Evacuation
Access
Service Animals
Drills and Location
Partners
Legal and Administrative Support
Legal
Administrative
Roles Outside of the Institution
Conclusion
References
Chapter 13: Critical Care Educational Modeling
Staff Education in the Modern Training Environment (Learner-Centered Model)
Learners
Educational Modalities
Competency-Based Training
Compassionate Coaching
Workplace-Based Assessment
Patient and Caregiver Education (Family-Centered Model)
Learners
Educational Modalities
Competencies
Simulation Training
Learners
Outline
Teaching at the Bedside and During ICU Rounds
Summary
References
Chapter 14: Humanizing Critical Care
What Is Humanization of the Intensive Care Units?
People Are at the Center of Humanization
Different Views of Humanization
Care Provider Skill Set
Scope of Humanization
Talk to Me
What Are We Waiting For?
The Integration of Intensive and Palliative Care
References
Chapter 15: Billing and Coding
Introduction
Disease-Related Group
Critical Care Services
Critical Care Time
Shared Time-Split Time
Teaching Time
Nonphysician Practitioner (NPP) Billing
Incident to Billing
Direct Billing
Split/Shared Billing
Conclusions
References
Chapter 16: Intensive Care Burnout
History
Definition and Measurement
Prevalence
Risk Factors
Consequences
Solutions
Conclusion
References
Chapter 17: Complementary Therapies
Introduction and Definitions
Prevalence
Nurses and CAT
CAT in the ICU
Evidence-Based Support for CM
Educational Programs
Consequences
Conclusions
References
Chapter 18: Establishing a Research Program in the ICU
Introduction
Types of Research Programs
Research in the Community Setting
Collaborative Research
Identifying Opportunities for Research
The Business Plan for Research
The Research Team
The Investigator
The Research Coordinator
Other Team Members
Role of the Program Manager
Study Execution in an ICU
Protocol Submission
Screening and Enrollment
Publication
Ethical Considerations
Attending and Enrolling Simultaneously
Co-enrollment
Enrollment of Patients at High Risk of Death
The Institutional Review Board (IRB)
Informed Consent
Metrics for a Research Program
Improving Patient Outcomes
Supporting Future Opportunities
Summary
References
Chapter 19: The Safety of Patients in Critical Care
Introduction
Patient Safety: Definitions
The Genesis of Incidents and Adverse Events
Patient Safety in Critical Care Services
Safety Practices
Notifying Patients and Relatives of an Incident Related to Patient Safety (IRPS)
Legal Aspects
Support for Professionals Involved in an Adverse Event
References
Index