“Technology is there to serve the patient first, but most importantly, to serve the care alliance of patients and practitioners,” says Dr. Buchman “I think some [advancements] are simply technical toys that are replacing what humans can already do.”
Technology can help identify a disease outbreak or other disaster faster than humans can. Some hospital systems are using surveillance systems that link across their facilities to find patterns. These systems can be used to find medical errors, but they can also act as bio-disease surveillance systems, which can be used to identify a sudden outbreak.
“Say three different hospitals each admit one patient with diarrhea,” says Dr. Farmer. “What if this is the beginning of an outbreak of something? A system that links across hospitals can find these patterns.”
The Critical Care Team of the Future
Today’s most highly developed ICUs are utilizing trained critical care teams to ensure the best possible care. In the future, all ICUs will follow this model in order to improve patient safety and efficiency of care.
These teams can include “not only physicians and nurses, but also respiratory therapists, nutritional support staff, and pharmacists, who collectively function as a highly integrated team, following protocols,” says Dr. Buchman. “This team formulates a patient plan together and evaluates the impact of that plan. I think we’re seeing more of that now, and we’re going to see a lot more of it. It’s a continuum; a growth process.
“This is not restricted to medical care; it will include social and spiritual care as well, with a team of case managers, social workers, and chaplains,” he continues. “These professionals contribute to the integrated care plans.”
Dr. Rainey agrees. “We’ll see a reorganization of physician services into an intensivist team model,” he predicts. “The development we’ve seen over the last 20 years is that outcomes are better with a unit-based special team that manages patients in cooperation with the primary care physician. In fact, this approach has shown something like a 30% decrease in risk for mortality.”
This team approach also applies to hospital disaster preparedness. In his white paper “Hospital Disaster Medical Response: Aligning Everyday Requirements with Emergency Casualty Care,” Dr. Farmer says, “ … we are witnessing the rapid development and emergence of medical emergency teams, or rapid response teams within the hospital. … These teams are intended to monitor inpatients and intervene before physiological deterioration supervenes. One might ask, in the event of a medical disaster, could these teams be repurposed for sophisticated casualty care and ICU expansion? We think it is logical that these types of critical care ‘outreach’ teams, in conjunction with noncritical care hospital personnel, could be leveraged as an effective strategy to extend ICU capabilities during a disaster.”
Having a complete team of ICU providers address each patient’s needs will vastly improve quality of care, but these teams must have some guidelines to follow in order to ensure that they work at maximum efficiency.
Critical Care Guidelines: An Integral Component
Critical care experts shy away from such buzzwords and phrases as “standardization of care” in regard to ICU practices, but they do agree that universal guidelines will be the norm in the future.
“We’ll see the development of drastically improved outcomes, and reduction in harm through reliable processes,” says Dr. Rainey. “We can see, for example, that five things need to be done to every ventilated patient. With development of reliable processes in place, we can see that we will close the gap between intent and actual execution.”