Systematized and efficient: organization of critical care in the future

Critical illness is a continuum, but patient care is often fragmented. Value-based critical care focuses on the overall health of the patient, not on an episode of care. The “ICU without borders” model incorporates a concept where members of the critical care team are involved in the management of patients from the onset of critical illness until recovery and beyond. In this paper, we summarise the potential benefits and challenges to patients, families, staff and the wider healthcare system and list some essential requirements, including a tight governance framework, advanced technologies, investment and trust. We also argue that “ICU without borders” should be viewed as a bi-directional model, allowing extended visiting hours, giving patients and families direct access to experienced critical care staff and offering mutual aid when needed.

show abstract

“…Lastly, it provides great opportunities for multi-disciplinary research into all phases of critical illness. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 11 , 12 ] Finally, post-ICU follow-up clinics can offer care for family members who may be at risk of physical exhaustion, post-traumatic stress disorder, anxiety, and depression. [ 13 ]…”

Section: Premises and Opportunitiesmentioning

confidence: 99%

ICU without borders

Ostermann

Vincent

2023

Crit Care

View full text Add to dashboard Cite

show abstract

“…End-of-life care in the ICU and subsequent postmortem healthcare (the Autopsy) have been made challenging to quantify by poor documentation in the medical record [28,29]. Patients who stay longer are more likely to develop and, subsequently, have a major error discovered postmortem [30].…”

Section: Scrutiny Of Intensive Care Unit As An Exclusion Criterionmentioning

confidence: 99%

Postmortem Gone Astray—A Systematic Review and Meta-Analysis

Šoša,

Perković

2024

Forensic Sciences

View full text Add to dashboard Cite

Premortem clinical diagnoses and postmortem autopsy findings do not match historically. These clinicopathological discrepancies are expected to be higher during the coronavirus disease 2019 (COVID-19) pandemic due to increased pressure on healthcare. At the same time, autopsies and clinicopathological discrepancies accurately display the quality of the healthcare system. To assess that, we examined the relevant works of literature according to the PRISMA-based protocol. As a discrepancy rate change-related antemortem scrutiny of medical care in the hospital, we also checked whether studies with patients from the intensive care unit (ICU) differed in discrepancies significantly. We found similar overall risk differences in “pre-COVID” and “during the pandemic” groups of studies. Based on this, we concluded that healthcare quality did not drop significantly during the pandemic. Be that as it may, the pandemic exposed some shortcomings in mortem healthcare regarding consensus to the autopsy, organ retention, burial, and the postponed burial or the digitalization of postmortem healthcare. All of these issues should be addressed in the future.

show abstract

“…End-of-life care in the ICU and subsequent postmortem healthcare (the Autopsy) have been made challenging to quantify by poor documentation in the medical record [68,69]. Patients who stay longer are more likely to develop and, subsequently, have a major error discovered post-mortem [70].…”

Section: Scrutiny Of Intensive Care Unit As An Exclusion Criterionmentioning

confidence: 99%

Postmortem Gone Astray

Šoša,

Perković

2023

Preprint

View full text Add to dashboard Cite

Premortem clinical diagnoses and postmortem autopsy findings do not match throughout history. These clinicopathological discrepancies are expected to be raised during the coronavirus disease 2019 (COVID-19) pandemic due to increased pressure on healthcare. At the same time, autopsies and clinicopathological discrepancies accurately display the quality of the healthcare system. To assess that, we examined the relevant works of literature according to the PRISMA-based protocol. As discrepancy rate changes in the correlation to the length of stay in the hospital, we also checked whether studies with patients from the intensive care unit (ICU) differed in discrepancies significantly. We found overall risk differences pretty much alike in "pre-COVID" and "during the pandemic" groups of studies. Based on that, we concluded that healthcare quality did not drop significantly during the pandemic. Be it as it may, the pandemic exposed some shortcomings in mortem healthcare regarding consensus to the autopsy, organ retention, burial, and the postponed burial or the digitalization of post mortem healthcare. All of these issues should be addressed in the future.

show abstract

Systematized and efficient: organization of critical care in the future

Cited by 6 publications

References 39 publications

ICU without borders

ICU without borders

Postmortem Gone Astray—A Systematic Review and Meta-Analysis

Postmortem Gone Astray

Contact Info

Product

Resources

About