SCCM Resource Library-Geographic Versus Service Line Care of Patients: Do Boarders Go to Accepting ICU Team or Stay on the Specialty Service?

Video Transcription

Video Summary

The debate revolves around the question of whether patients admitted to off-service intensive care units (ICUs) should be followed by the specialty service or the local ICU team. Dr. Wendy Wright argues that patients should be followed by the specialty service, as it is more patient-centered and consistent with the concept of "right care right now." She believes that patients should receive care in a unit that aligns with their most relevant diagnosis, as specialty ICUs have specialized personnel, equipment, and protocols that best address their specific needs. Dr. Wright also emphasizes the importance of familiar clinical expertise and better patient and family support in specialty ICUs. She acknowledges the challenges of boarding and the need for flexibility, but advocates for aggressive repatriation of patients to their specialty units when beds become available. She also suggests educational efforts, promoting a sense of responsibility for boarding patients, and establishing clear communication channels between the boarding unit staff and the ICU team. On the other hand, Dr. Victoria McCready argues from the geographic focus side that it may be better for the assigned ICU team to take care of the patient. She highlights the potential problems of boarding patients in non-specialty or generalized ICUs, such as geographic barriers, differences in training and specialization of nurses and other team members, as well as the impact on intensivist-to-bed ratios. Dr. McCready questions the existing evidence supporting specialized neurocritical care and highlights the importance of considering ICU structure and standardized management protocols to improve outcomes in non-ideal specialty ICUs. Overall, the debate explores the trade-offs between specialty care and geographic focus in providing optimal care for patients boarding in ICUs.

Asset Subtitle

Administration, Crisis Management, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

These educational sessions present a wide range of critical care topics discussed by faculty from SCCM sections and are moderated by Neuroscience Section leaders.

Wendy L. Wright

Victoria A. McCredie

Meta Tag

Content Type Presentation

Knowledge Area Administration

Knowledge Area Crisis Management

Knowledge Level Advanced

Membership Level Select

Tag Transfers

Tag Resource Allocation

Year 2021

Keywords

specialty service

patient-centered

boarding

geographic focus

repatriation

protocols

ICU structure

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