Changing the Work Environment in ICUs to Achieve Patient-Focused Care

Changing the Work Environment in ICUs to Achieve Patient-Focused CareThe landmark Institute of Medicine (IOM) document To Err Is Human: Building a Safer Health System1 transformed the way we think about patients safety. By making public the dangers that patients face when they enter the current health-care system, the IOM used its influence effectively to call for dramatic transformations in the way we evaluate errors and changed the focus of error prevention from individual punishment to one of system redesign. In Crossing the Quality Chasm: A New Health System for the Twenty-First Century,2 the IOM then attacked the dysfunctional processes of our past and current health-care systems (eg, pervasive poor communication and noninterdisciplinary, often isolationist decision-making behavior). By focusing on effective team performance, data-driven analysis of system failures, and continuous process improvements to reduce risk, the IOM called for a revolution in the way we communicate with each other, anticipate and modify patients’ risk, and evaluate our effectiveness.
The leaders of the American Association of Critical-Care Nurses (AACN) and the American College of Chest Physicians (ACCP) have a long history of thoughtful dialogue about the important issues in critical care practice and have collaborated on key initiatives to enhance the practice knowledge of their members. Over the years, as their relationship hasmatured, the organizations have come to respect and value each other’s perspective, have benefited from the unique knowledge and worldview each brings to planning for the future, and have used this perspective to grow in ways that would not have been possible without this collaborative relationship. Source
As past presidents of the AACN (Dr. McCauley) and ACCP (Dr. Irwin), in this article we describe how the AACN Standards for Establishing and Sustaining Healthy Work Environments1 and the ACCP Patient-Focused Care Project demonstrate true collaboration and synergy of thought. Together, these complementary initiatives provide a road map for creating the kind of practice environment where interdisciplinary, patient-focused care, as called for by the IOM, can thrive.

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