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Team model: Advocating for the optimal method of care delivery in the intensive care unit

Durbin, Charles G. Jr MD, FCCM

Critical Care Medicine:
doi: 10.1097/01.CCM.0000199985.72497.D1
Model and Workforce
Abstract

Objective: To review published data on the team model of intensive care unit (ICU) care delivery.

Design: Nonexhaustive, selective literature search.

Setting: Review of literature published in the English language.

Patients/Subjects: Humans cared for in ICUs.

Interventions: None.

Results: The team model for delivery of ICU care reduces mortality, ICU length of stay, hospital length of stay, and cost of care. Convincing data suggest that merely having daily rounds led by an intensivist enhances patient care significantly. Further improvements can be obtained by maintaining a nurse-to-patient ratio of no greater than 1:2, adding critical care pharmacists, and providing dedicated respiratory therapists to the ICU team.

Conclusion: Current and looming shortages of all ICU healthcare providers is a barrier to universal implementation of the team model. Advocating for the ICU team model for critical care delivery requires local, regional, national, and international activities for success.

Author Information

From the Departments of Anesthesiology and Surgery, University of Virginia Health System, Charlottesville, VA.

The author has no financial conflicts of interest to declare.

© 2006 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins