Improving care of the critically ill: institutional and health-care system approaches.
Saved in:
| Title: | Improving care of the critically ill: institutional and health-care system approaches. |
|---|---|
| Authors: | Angus DC (AUTHOR), Black N (AUTHOR), Angus, Derek C (AUTHOR), Black, Nick (AUTHOR) |
| Source: | Lancet. 4/17/2004, Vol. 363 Issue 9417, p1314-1320. 7p. |
| Abstract: | Institutional and health-care system approaches complement bedside strategies to improve care of the critically ill. Focusing on the USA and the UK, we discuss seven approaches: education (especially of non-clinical managers, policy-makers, and the public), organisational guidelines, performance reporting, financial and sociobehavioural incentives to health-care professionals and institutions, regulation, legal requirements, and health-care system reorganisation. No single action is likely to have sustained effect and we recommend a combination of approaches. Several recent initiatives that hold promise tie performance reporting to financial incentives. Though performance reporting has been hampered by concerns over cost and accuracy, it remains an essential component and we recommend continued effort in this area. We also recommend more public education and use of organisational guidelines, such as admission criteria and staffing levels in intensive care units. Even if these endeavours are successful, with rising demand for services and continuing pressure to control costs, optimum care of the critically ill will not be realised without a fundamental reorganisation of services. In both the USA and UK, we recommend exploration of regionalised care, akin to US state trauma systems, and greater use of physician-extenders, such as nurse practitioners, to provide enhanced access to specialist care for critical illness. [ABSTRACT FROM AUTHOR] |
| Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 106558640 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Improving care of the critically ill: institutional and health-care system approaches. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Angus+DC%22">Angus DC</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Black+N%22">Black N</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Angus%2C+Derek+C%22">Angus, Derek C</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Black%2C+Nick%22">Black, Nick</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 4/17/2004, Vol. 363 Issue 9417, p1314-1320. 7p. – Name: Abstract Label: Abstract Group: Ab Data: Institutional and health-care system approaches complement bedside strategies to improve care of the critically ill. Focusing on the USA and the UK, we discuss seven approaches: education (especially of non-clinical managers, policy-makers, and the public), organisational guidelines, performance reporting, financial and sociobehavioural incentives to health-care professionals and institutions, regulation, legal requirements, and health-care system reorganisation. No single action is likely to have sustained effect and we recommend a combination of approaches. Several recent initiatives that hold promise tie performance reporting to financial incentives. Though performance reporting has been hampered by concerns over cost and accuracy, it remains an essential component and we recommend continued effort in this area. We also recommend more public education and use of organisational guidelines, such as admission criteria and staffing levels in intensive care units. Even if these endeavours are successful, with rising demand for services and continuing pressure to control costs, optimum care of the critically ill will not be realised without a fundamental reorganisation of services. In both the USA and UK, we recommend exploration of regionalised care, akin to US state trauma systems, and greater use of physician-extenders, such as nurse practitioners, to provide enhanced access to specialist care for critical illness. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=106558640 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/s0140-6736(04)16007-8 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 1314 Titles: – TitleFull: Improving care of the critically ill: institutional and health-care system approaches. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Angus DC – PersonEntity: Name: NameFull: Black N – PersonEntity: Name: NameFull: Angus, Derek C – PersonEntity: Name: NameFull: Black, Nick IsPartOfRelationships: – BibEntity: Dates: – D: 17 M: 04 Text: 4/17/2004 Type: published Y: 2004 Identifiers: – Type: issn-print Value: 01406736 Numbering: – Type: volume Value: 363 – Type: issue Value: 9417 Titles: – TitleFull: Lancet Type: main |
| ResultId | 1 |
