on the cusp stop bsi icu physician staffing n.
Skip this Video
Loading SlideShow in 5 Seconds..
On the CUSP: STOP BSI ICU Physician Staffing PowerPoint Presentation
Download Presentation
On the CUSP: STOP BSI ICU Physician Staffing

Loading in 2 Seconds...

play fullscreen
1 / 17

On the CUSP: STOP BSI ICU Physician Staffing - PowerPoint PPT Presentation

  • Uploaded on

On the CUSP: STOP BSI ICU Physician Staffing. Learning Objectives. To review the evidence on the benefits of ICU physician staffing To explore strategies to improve ICU physician staffing. Organizing Principles for Intensive Care. Intensivists Reduce Mortality Costs.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'On the CUSP: STOP BSI ICU Physician Staffing' - dasan

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
learning objectives
Learning Objectives
  • To review the evidence on the benefits of ICU physician staffing
  • To explore strategies to improve ICU physician staffing
intensivists reduce mortality costs

Intensivists Reduce Mortality Costs

Question is not Whether to but How to implement IPS

leapfrog model net savings for hospital 000
Leapfrog modelNet savings for hospital $000

Conrad, Gardner 2004 Leapfrog report

net savings per icu day leapfrog model
Net Savings per ICU day Leapfrog model $

Conrad, Gardner 2004 Leapfrog report






Insurer to Provide Bonuses to Hospitals

That Rapidly Adopt Proven Patient Safety Programs

NEW YORK (10/18/01) – IBM, PepsiCo, Inc., Verizon Communications and Xerox Corporation announced today that they will join Empire Blue Cross and Blue Shield in an innovative program designed to save lives by providing financial incentives to hospitals that rapidly achieve proven patient safety standards.

key attributes of physician staffing
Key Attributes of Physician Staffing
  • Present
  • Posses skill/knowledge
  • Communicates/works with team of caregivers
  • Manages the ICU

Little is known about the relative value of each attribute


24 X 7


team care
Team Care
  • Avoid Open versus Closed debate
    • Both primary care and ICU physician add value
  • Obtain financial support from hospital for physician staffing
  • Create Compact of what is expected
  • Include performance measures in contract
  • Obtain admission and discharge authority
strategies for implementing intensivists
Strategies for Implementing Intensivists
  • Meet with medical staff
    • Review evidence
    • Discuss team approach rather than open closed
  • Create Compact with hospital
    • Hospital to provide financial support
    • Intensivists will staff ICU, monitor and improve quality
    • Review performance quarterly
how can you realize these attributes without intensivists
How Can You Realize these Attributes without Intensivists
  • Discuss alternative models
    • Hospitalist
    • Regionalization
    • NP/PA
    • Other
  • Ensure a physician rounds on all patients every day
  • Call list
action plan
Action Plan
  • Discuss with team and hospital your current ICU physician staff, are you meeting the 4 attributes
  • Develop plan to enhance ICU physician staffing
  • Ensure nurses know which physician to page for all patients at all times
  • Create explicit Compact; hospital will provide financial support and physician will provide services
  • Levy MM, Rapoport J, Lemeshow S, Chalfin DB, Phillips G, Danis M. Association between critical care physician management and patient mortality in the intensive care unit. Ann Int Med 2008;148:801-9.
  • Pronovost PJ, Holzmueller CG, Clattenburg L, Berenholtz S, Martinez EA, Paz JR, Needham DM. Team care: beyond open and closed intensive care units. Curr Opin Crit Care 2006;12:604-8.
  • Pronovost PJ, Needham DM, Waters H, Birkmeyer CM, Calinawan JR, Birkmeyer JD, Dorman T. Intensive care unit physician staffing: Financial modeling of the Leapfrog standard. Crit Care Med 2006;34:S18-24.
  • Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA 2002;288:2151-62.
  • Pronovost PJ, Jenckes MW, Dorman T, Garrett E, Breslow MJ, Rosenfeld BA, Lipsett PA, Bass E. Organizational characteristics of intensive care units related to outcomes of abdominal aortic surgery. JAMA 1999;281:1310-17.