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February 22, 2010

Engineering Health in the Intensive Care Unit

Author Affiliations

Author Affiliation: Critical Care Center and Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston.

Arch Intern Med. 2010;170(4):319-320. doi:10.1001/archinternmed.2009.528

In this issue of the Archives, Kim et al1 report on a retrospective cohort study of more than 100 000 medical patients admitted to acute care hospitals in the state of Pennsylvania. The authors hypothesized that the presence of a multidisciplinary team responsible for care of patients in the intensive care unit (ICU) would exert an effect, independent of the presence of an intensivist, on outcome in these patients. Their analysis indicates that daily rounds by a multidisciplinary team were associated with lower mortality in the cohort of patients studied (restricted to medical ICUs). They conclude that the survival benefit of intensivist physician ICU staffing is in part explained by its association with multidisciplinary, team-based care. This study is published at an important point in the evolution of America's health care system and should help refocus performance improvement initiatives for critical illness and injury.

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