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Transfer from ICU

Ante Ćorić ante.coric85 at gmail.com
Fri May 6 14:43:07 BST 2011


We do not allow a surgeon, non intensivist to deal with ICU patients, except
for consults. This practice is worldwide and has proven to improve survival
of ICU patients, therefore all ICUs should be closed ones, but due to
money/staff lack not all can be.
There are plenty of ways to improve communication between patients and their
surgeons throughout hospital stay, regardless of dept where patients are
admitted.

Ante

2011/5/4 McSwain, Norman E <nmcswai at tulane.edu>

> Thanks
>
> Norman
> Norman McSwain MD, FACS
> Professor, Tulane School of Medicine
> President, Orleans Parish Medical Society
> Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO
> norman.mcswain at tulane.edu
> 504 988 5111
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Doc Holiday
> Sent: Tuesday, May 03, 2011 8:47 AM
> To: .Trauma List
> Subject: RE: Transfer from ICU
>
>
> >...What mechanism have you found that works consistently...
>
> --> How about setting a protocol KEEPING the surgeon who was initially
> involved (before ICU), co-rounding on the patient with the ICU staff,
> or, if schedules do not permit, surgeon does a daily round alone on
> his/her ICU patients and thus there are no surprises. ICU patients
> unlikely to object to this. Surgeon maintains "ownership"
> before-during-post-ICU. If there is more than one surgical specialty
> involved initially or at any stage, then they can round together, OR
> separately, OR decide to leave future care for only one of htem to
> continue.
>
> The rule will be that no patient can be in ITU without a NAMED
> non-ITU-specialist also in in co-charge of care and responsibility, i.e.
> the patient already belongs to the "floor" doc WHILE the patient is in
> ITU and it's the "floor" doc's responsibility to keep AT LEAST up to
> date on that patient, if not actively co-managing with the intensivist.
>
> At the same time this is brought in, institute an audit of when things
> go wrong and initiate mandatory re-training or disciplinary action for
> any staff who fail to follow transfer protocols (only the first few will
> need to happen before the message gets through).
>
> Both actions together cannot be seen as merely punitive, as the first
> idea is quite clearly of benefit to the patient.
>
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