The Future of Critical Care: Optimizing Technologies and a Learning Healthcare System to Potentiate a More Humanistic Approach to Critical Care

Meissen, Heather; Gong, Michelle N.; Wong, An-Kwok Ian; Zimmerman, Jerry J.; Nadkarni, Nalini M.; Kane-Gil, Sandra L; Amador-Castaneda, Javier; Bailey, Heatherlee; Brown, Samuel M.; DePriest, Ashley; Eche, Ifeoma Mary; Narayan, Mayur; Provencio, J. Javier; Sederstrom, Nneka; Sevransky, Jonathan; Tremper, Jordan; Aslakson, Rebecca

doi:10.1097/cce.0000000000000659

Cited by 19 publications

(14 citation statements)

References 45 publications

(47 reference statements)

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“…In this study, we sought to better understand clinicians’ experiences with and perceptions of technology in ICUs. New technologies are essential to ICUs’ ability to manage severe illness, injuries, and complications and indeed were one rationale for the early use of ICUs (Meissen et al, 2022). New technologies have clearly improved care and saved lives (Weil & Tang, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Care in modern ICUs now combines multidisciplinary expertise and a complex array of equipment and technology (Marshall et al, 2017). These technologies, which on average generate over 1,000 data points daily per ICU patient (Manor-Shulman et al, 2008; Meissen et al, 2022), have clearly advanced clinicians’ ability to care for patients by enabling precise monitoring for early complication detection, facilitating efficient treatment strategies, and providing advanced life support systems and real-time data analysis (Weil & Tang, 2011).…”

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confidence: 99%

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More isn’t always better

Olsen,

Novikov,

Sakata

et al. 2024

Health Care Manage Rev

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Background Clinical care in modern intensive care units (ICUs) combines multidisciplinary expertise and a complex array of technologies. These technologies have clearly advanced the ability of clinicians to do more for patients, yet so much equipment also presents the possibility for cognitive overload. Purpose The aim of this study was to investigate clinicians’ experiences with and perceptions of technology in ICUs. Methodology/Approach We analyzed qualitative data from 30 interviews with ICU clinicians and frontline managers within four ICUs. Results Our interviews identified three main challenges associated with technology in the ICU: (a) too many technologies and too much data; (b) inconsistent and inaccurate technologies; and (c) not enough integration among technologies, alignment with clinical workflows, and support for clinician identities. To address these challenges, interviewees highlighted mitigation strategies to address both social and technical systems and to achieve joint optimization. Conclusion When new technologies are added to the ICU, they have potential both to improve and to disrupt patient care. To successfully implement technologies in the ICU, clinicians’ perspectives are crucial. Understanding clinicians’ perspectives can help limit the disruptive effects of new technologies, so clinicians can focus their time and attention on providing care to patients. Practice Implications As technology and data continue to play an increasingly important role in ICU care, everyone involved in the design, development, approval, implementation, and use of technology should work together to apply a sociotechnical systems approach to reduce possible negative effects on clinical care for critically ill patients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

More isn’t always better

Olsen,

Novikov,

Sakata

et al. 2024

Health Care Manage Rev

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“…Wearable technologies and home-based rehabilitation programs have been shown to better identify and also ameliorate symptoms of post-intensive care syndrome. [ 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%

“…Technologies are available to better track and pass on patients’ preferences, such as advance directives and organ donation wishes. [ 11 ] It is very likely that future critical care will potentially include the patient’s home and field hospitals, similar to critical care telemedicine programs that support remote or low-resource environments with virtual input from experts around the world. [ 11 ]…”

Section: Premises and Opportunitiesmentioning

confidence: 99%

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ICU without borders

Ostermann

Vincent

2023

Crit Care

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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.

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Role of artificial intelligence in critical care nutrition support and research

Kittrell,

Shaikh,

Adintori

et al. 2024

Nut in Clin Prac

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Nutrition plays a key role in the comprehensive care of critically ill patients. Determining optimal nutrition strategy, however, remains a subject of intense debate. Artificial intelligence (AI) applications are becoming increasingly common in medicine, and specifically in critical care, driven by the data‐rich environment of intensive care units. In this review, we will examine the evidence regarding the application of AI in critical care nutrition. As of now, the use of AI in critical care nutrition is relatively limited, with its primary emphasis on malnutrition screening and tolerance of enteral nutrition. Despite the current scarcity of evidence, the potential for AI for more personalized nutrition management for critically ill patients is substantial. This stems from the ability of AI to integrate multiple data streams reflecting patients' changing needs while addressing inherent heterogeneity. The application of AI in critical care nutrition holds promise for optimizing patient outcomes through tailored and adaptive nutrition interventions. A successful implementation of AI, however, necessitates a multidisciplinary approach, coupled with careful consideration of challenges related to data management, financial aspects, and patient privacy.

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The Future of Critical Care: Optimizing Technologies and a Learning Healthcare System to Potentiate a More Humanistic Approach to Critical Care

Cited by 19 publications

References 45 publications

More isn’t always better

More isn’t always better

ICU without borders

Role of artificial intelligence in critical care nutrition support and research

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