May 6, 2009 > Right Care, Right Now
Right Care, Right Now
'Intensivists' Improve Quality of Care in the ICU
A surgeon performs surgeries. A pediatrician treats children. A cardiologist cares for people with heart disease. But what does an "intensivist" do?
"Intensivists are physicians who direct and provide medical care in a hospital's intensive care unit (ICU), working with the attending physician of record and other staff such as critical care nurses, pharmacists, respiratory therapists, nutritionists, rehabilitation services, social workers, case managers and especially spiritual care - as well as physician specialists," explains Dr. Carmencita Agcaoili, Medical Director of the Intensivist Program at Washington Hospital.
"An intensivist has completed a primary residency and board certification in a specialty such as surgery, internal medicine, anesthesiology or pediatrics and an additional two- to three-year fellowship and certification in critical care medicine," she adds.
Launched in January 2008, the Intensivist Program at Washington Hospital currently has an intensivist available in the ICU every day from 7 a.m. to 7 p.m., as well as some nights. On-call intensivist coverage is provided 24/7, and the hospital plans to expand the program further to include additional intensivists on site around the clock.
Washington Hospital's Intensivist Program follows the evidence-based guidelines for care established by the Society of Critical Care Medicine (SCCM). The SCCM critical care model calls for a multidisciplinary team approach that has a well-documented record of:
* Improving patient survival rates and quality care.
* Decreasing procedure complications.
* Promoting medication safety.
Prepared for action
Patients in the ICU generally have life-threatening illnesses or conditions such as cardiac arrest, respiratory failure, strokes, severe trauma or resistant infections," Dr. Agcaoili notes. "Because of their unstable conditions, these patients must be monitored much more closely than patients in regular hospital wards. Studies have shown that having an intensivist act as the team leader in providing critical care definitely improves the quality of care for these patients."
Board certified in all three specialties - internal medicine, pulmonary medicine and critical care, Dr. Agcaoili moved to Fremont in 1991 and began her long association with Washington Hospital. "This is my community, and it is important to me to be actively involved in providing the best possible care for people in our community," she says. "I get a real sense of fulfillment in caring for patients who are fragile and are at a crucial point in their lives."
In addition to Dr. Agcaoili, the Intensivist Program includes Dr. Vineet Kapur, a board certified physician in both internal medicine and critical care and Dr. Omeed Azizirad, who just finished his critical care fellowship training from Stanford University Medical Center.
"We are expanding our Family Assistance Program to help provide families with more information and to train the ICU staff in how to care for the needs of family members," she adds. "We also offer classes for doctors and other staff in the Fundamentals of Critical Care. The classes have been very well received, and physicians have embraced the idea of the multidisciplinary ICU team. It truly is a team effort."
The ultimate goal of the Intensivist Program at Washington Hospital is embodied in the SCCM's "Right Care, Right Now(tm)" campaign. "The objective is to provide the right care at exactly the right moment in time to achieve the best possible patient outcome," Dr. Agcaoili explains. "The intensivist-led model for critical care has become the 'gold standard.' It is focused on patient safety. It improves patient outcomes. It reflects the patient-first ethic of Washington Hospital. It's the right thing to do for our patients."
Compassionate Critical Care
For more information about critical care medicine and the role of intensivists in the ICU, visit the SCCM website at www.myicucare.org.