Posted by Bill Sandweg on 11 May 2011.
It is not our purpose to mindlessly bash the medical profession. There are many competent and caring physicians and nurses providing quality care to patients. Unfortunately, there are also doctors and nurses who are not as competent or as caring and who provide substandard care. It is they who most frequently cause harm to their patients.
Today, I want to recognize the people who run the ICU program at Montefiore Medical Center in Bronx, N.Y. Montefiore is the university hospital for Albert Einstein College of Medicine. The College has one of the largest training programs for critical care specialists in the United States. The doctors at Montefiore, led by Dr. Vladimir Kvetan, director of critical care medicine, have developed a number of innovative programs to make the operation of the hospital’s ICU’s more efficient.
Among their innovations is a concept they call “ICU without walls” in which ICU level care can be offered anywhere in the hospital, if an ICU bed is not immediately available. They also use a “closed” ICU system in which the decision to admit a patient to the ICU is in the hands of critical care specialists as opposed to the usual attending physician. This helps to assure that those patients who are admitted to the ICU are those who will be most likely to benefit from that level of care. Another innovation is the creation of rapid response teams which can go anywhere in the hospital to care for a deteriorating patient with the goal of responding early and preventing cardiac arrests.
The ICU innovations at Montefiore have undoubtedly been a factor in improved statistics at the hospital. For example, in 2009, the in-hospital mortality for patients who stayed in a Montefiore ICU was 33% lower than expected for patients around the country with similar symptoms.
As a society, we should encourage innovative thinking which improves efficiency and patient outcomes. Congratulations to the doctors and nurses at Montefiore Medical Center.
Here is a link to an article in the Wall Street Journal describing the program and its accomplishments in more detail. http://online.wsj.com/article/SB10001424052748704132204576190632996146752.html