NDLI: Delivery of critical care in North American burn centers.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Reimel, Beth Ann Klein, Matthew B. Nathens, Avery B. Gibran, Nicole S.
Spatial Coverage	North America
Description	Country affiliation: United States Author Affiliation: Reimel BA ( Department of Surgery, University of Washington Burn Center, Seattle, WA 98104, USA.)
Abstract	The management of severely ill patients is an essential component of burn management. As critical care practices become more specialized, and payers such as the Leapfrog group insist on organizational structure for critical care delivery, we sought to determine how critical care is delivered in North American burn centers. Many surgical and medical intensive care units (ICUs) follow an intensivist model with the following features: 1) ICU physician-director is board-certified in critical care, 2) more than 50% of the ICU physicians are board-certified in critical care, and 3) an intensive care team has authority to write patient orders. We hypothesized that the intensivist model is uncommon in North American burn centers. One hundred twenty-seven burn surgeons were surveyed using a web-based questionnaire that addressed institutional volume, attending critical care certification, involvement of intensivist teams, and implementation of evidenced-based practices. A total of 64 surgeons completed the survey (51%). In accordance with several intensivist, model criteria varied by ICU volume and verification status. Lower ICU volume centers are more likely to have an intensivist team that rounds daily (69% vs. 29%, P = .02). Nonverified centers are more likely to have ICU attending without responsibilities outside of the ICU (22% vs. 0%, P = .01). Verified centers are more likely to have dedicated ICU morbidity and mortality conferences (63% vs. 35%, P = .02). Results of this survey indicate that many North American Burn Centers do not use the intensivist model of critical care delivery.
File Format	HTM / HTML
ISSN	1559047X
Issue Number	5
Volume Number	29
e-ISSN	15590488
Journal	Journal of Burn Care & Research
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Traumatology Burn Units Organization & Administration Burns Critical Care Methods Critical Illness Health Care Surveys Humans Intensive Care Units North America Journal Article Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Rehabilitation Surgery

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