Changing the Work Environment in ICUs to Achieve Patient-Focused Care: Essential Need for Innovative Care Models

Changing the Work Environment in ICUs to Achieve Patient-Focused Care: Essential Need for Innovative Care ModelsIn designing a new and more effective structure, the UMass Memorial Medical Center team learned that it needed to communicate more effectively and in the process has strengthened its interdisciplinary relationships. Team members have more consistently come to understand and appreciate the perspective of others and, by constantly focusing on what is best for patients and patients’ families, are better able to resolve conflicts, solve problems, and refocus attention toward teamwork and quality evidence-based, patient-focused care. Only time will tell how successful the virtual department will be. However, it was clearly time for a change because the 20th-century model of delivering critical care has too many flaws, flaws that the IOM says portray all of medicine.
We suspect that other innovative models remain unreported, and we urge readers to communicate their successes and, yes, failures to the professional community. We challenge readers to engage in this essential work of designing innovative care delivery. Consider what is required so that skilled communication, true collaboration, and patient-focused care can become the norm at your institution.
Which colleagues will be your immediate and eager allies in designing, implementing, and evaluating these changes? How will you ensure that all disciplines participate? What resources will be needed to support this transformation? How will the requisite energy and enthusiasm be sustained in order to persevere in such a strategically essential process? How will successes and failures be celebrated and learned from along the journey?
If the health-care system in which you work will not allow the delivery of critical care to be transformed into an efficient, patient-focused, healthy work environment, perhaps it is time for you and your colleagues to suggest to the chief executive officer and other clinical leaders that it might be time to undertake a strategic planning process with the goal of redesigning critical care.
Linking patient-focused care, as defined by the ACCP, with work environment transformation, based on the AACN healthy work environment standards, will strengthen process and outcome by identifying a mutual purpose that unites disciplines in a common effort built on shared values. This framework offers a road map to collaboratively achieve the vision of a health-care system driven by the needs of patients and their families in which each discipline makes its optimal contribution. Pronovost and his colleagues are correct. Our disciplines are interdependent and must be integrated. Only then will we be supported in making our optimal contribution.

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