How the COVID-19 pandemic will change the future of critical care

Abstract

Coronavirus disease 19 (COVID-19) has posed unprecedented healthcare system challenges, some of which will lead to transformative change. It is obvious to healthcare workers and policymakers alike that an effective critical care surge response must be nested within the overall care delivery model. The COVID-19 pandemic has highlighted key elements of emergency preparedness. These include having national or regional strategic reserves of personal protective equipment, intensive care unit (ICU) devices, consumables and pharmaceuticals, as well as effective supply chains and efficient utilization protocols. ICUs must also be prepared to accommodate surges of patients and ICU staffing models should allow for fluctuations in demand. Pre-existing ICU triage and end-of-life care principles should be established, implemented and updated. Daily workflow processes should be restructured to include remote connection with multidisciplinary healthcare workers and frequent communication with relatives. The pandemic has also demonstrated the benefits of digital transformation and the value of remote monitoring technologies, such as wireless monitoring. Finally, the pandemic has highlighted the value of pre-existing epidemiological registries and agile randomized controlled platform trials in generating fast, reliable data. The COVID-19 pandemic is a reminder that besides our duty to care, we are committed to improve. By meeting these challenges today, we will be able to provide better care to future patients.

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

“…Even after hospital visitor restrictions are relaxed, many family members will be unable to visit the ICU: it is increasingly common for family members to live in a different state than their loved one ( Douglas et al, 2016 ), and prior studies have shown that over half of family caregivers are also actively employed or lack ready transportation ( Carson et al, 2016 , Cox et al, 2019 ). While in-person communication can and should return to being the primary mode of family engagement once visitors return, virtual communication will continue to be of benefit for caregivers who cannot be present but wish to remain engaged ( Arabi et al, 2021 ). HCWs commented on the challenges of communicating with patients and families with Limited English Proficiency (LEP).…”

The impact of COVID-19 on nursing workload and planning of nursing staff on the Intensive Care: A prospective descriptive multicenter study

“…A study from Arabi et al described different methods to expand the ICU staffing pool during the COVID-pandemic, e.g. optimizing ICU-nursing capacity by increasing the number of patients per nurse and the use of non-ICU staff to reinforce the ICU staff ( Arabi et al, 2021 ). Also in the Netherlands the ICU nurses were supported by non-ICU nurses for basic care, but the ICU nurses were still responsible for the wellbeing of a higher number of patients during their shift.…”

COVID‐19 highlights the need to optimize critical care resource use: The role of a respiratory‐led multidisciplinary team

“…Alastair Watson PhD 1,2 Lucie Linhartova FRCA, FFICM 1 Paul Ellis MRCP 1 Rahul Mukherjee FRCP (London), FRCP (Edin. ), FCCP 1 1 Heartlands Hospital, University Hospitals Birmingham, UK…”