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Team Approach to Critical Care Saves Lives at Washington Hospital

May 14, 2013

Washington Hospital Recognizes Critical Care Specialists

Critical care specialists treat the most gravely ill patients in the hospital setting; those who are clinging to life due to a medical condition like cancer, stroke, or heart disease or victims of a serious accident like a car crash. Nearly 80 percent of us will be affected by a life-threatening illness or injury in the course of our lifetime, according to the Society of Critical Care Medicine.

"During Critical Care Awareness Month in May, we recognize the contributions of these specially trained healthcare professionals," said Dr. Carmencita Agcaoili, a critical care pulmonologist and medical director of the Intensivist Program at Washington Hospital. "We are dedicated to providing the best care possible to the most critically ill patients we serve."

Washington Hospital is on the leading edge of critical care medicine. The hospital will open a new state-of-the-art critical care pavilion in 2016 and is one of the few hospitals that has an intensivist available 24 hours a day, seven days a week.

Intensivists are physicians who direct and provide medical care for patients in the intensive care unit (ICU), where critically ill patients are treated. They are board-certified in critical care medicine and in a primary specialty such as internal medicine, surgery, anesthesiology, or pediatrics.

Intensivists work with the attending physician and other members of the critical care team such as critical care nurses, pharmacists, respiratory therapists, nutritionists, rehabilitation services, social workers, case managers, and physician specialists as well as spiritual care staff and volunteers.

Right Care, Right Now

"The goal of critical care medicine is to provide the right care, right now for the best possible patient outcome," Dr. Agcaoili explained. "These patients are facing life-threatening illnesses and injuries, so they need to be carefully monitored and treated as situations arise. That requires a multidisciplinary team of specially trained professionals who are ready to jump in and provide the exact care the patient needs at any given moment."

A 2010 study published in the Archives of Internal Medicine found that the death rate among patients was lowest at hospitals that use this type of multidisciplinary team led by a trained intensivist. Washington Hospital launched its Intensivist Program in 2008 and now has 10 intensivists who are part of the medical staff.

Washington Hospital is also on the forefront with its efforts to better understand and reduce the incidence of delirium among ICU patients, according to Dr. Agcaoili. Delirium is a state of confusion that can come on very rapidly. Patients who suffer from delirium can't think clearly, have trouble paying attention, and may not be aware of what is going on around them. They may even experience hallucinations.

"This is a common problem with ICU patients, particularly those who are on mechanical ventilation," she said. "There can be lasting side effects from experiencing delirium. Sometimes the brain does not function properly even after patients are discharged from the hospital. So we have to get a handle on this problem."

Family Affair

A life-threatening illness or injury doesn't just affect the patient, it also has a serious impact on their family and other loved ones. Washington Hospital's Family Assistance Program addresses the needs of critical care patients and their families.

"This can be an incredibly difficult time for families and they need help getting through it," Dr. Acgaoili said. "Often they can't talk to their loved ones because they are on a ventilator or too ill to speak. They are trying to figure out what is best for the patient."

The ICU itself can also be overwhelming, she added. It is filled with monitors and other high-tech equipment that can be intimidating and scary.

She said families are an important part of the ICU team. They are encouraged to stay in the room during rounds so they know what is happening and can understand the goals for the day. Family members can also help in their loved one's recovery, often just by being present.

"Washington Hospital is intensely focused on providing state-of-the art medical care, including critical care," Agcaoili said. "From the Intensivist Program to the new critical care pavilion, the hospital is well-positioned to provide the best critical care medicine possible to our local community."

For more information about Washington Hospital's Intensivist Program, visit http://www.whhs.com/intensivist-program.

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