Reducing the impact of critical illness

The University of Michigan Health System has joined an innovative national quality project called ICU Liberation that includes 77 U.S. hospitals working to change the landscape of intensive care.

The U-M Surgical Intensive Care Unit will examine care processes that impact quality of life during and after critical illness. Experts now recognize that of the millions of patients who survive life-threatening illness each year, as many as half may go on to develop post-intensive care syndrome (PICS), a condition that includes ongoing muscle weakness and brain dysfunction from memory loss to depression and anxiety.

“ICU Liberation aims to reduce the harmful consequences of ICU care and focuses on directly improving the lives of critically ill patients and their families,” says Marge Calarco, Ph.D., R.N., chief nurse executive at UMHS and adjunct professor of nursing at the University of Michigan. “This is a clear example of how we are seeking to continuously improve our care and meet the expectations of patients and families.”

ICU Liberation focuses on use of an updated ABCDEF bundle to minimize PICS:

A – Assess, prevent and manage pain

B – Both spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT)

C – Choice of analgesia and sedation

D – Delirium: assess, prevent and manage

E – Early mobility and exercise

F – Family engagement and empowerment

The U-M SICU’s multidisciplinary team includes critical care physicians and nurses, pharmacists, respiratory therapists, dieticians and physical, occupational and speech therapists, all collaboratively engaged in transforming ICU care to meet the goals of the ABCDEF Bundle project.

Implementation of the patient care standards may result in better outcomes for the 1,200 patients admitted to the University Hospital’s surgical intensive care unit each year.  The U-M is one of four Michigan hospitals participating in ICU Liberation.

The U-M SICU ICU Liberation leadership team includes Sharon Dickenson, R.N., Connie Rickelmann, R.N., James Miller, Pharm.D., Pauline K. Park, M.D., Lena Napolitano, M.D., Nichole Werner, M.D., and Adam Carter, M.D.

The initiative is sponsored by the Society of Critical Care Medicine and the Gordon and Betty Moore Foundation. They will work with hospitals to collect data through 2017 to support a database of 27,000 patient hospital stays.

Website: http://www.iculiberation.org/Pages/default.aspx