When the sickest patients are admitted to the hospital with potentially fatal heart conditions, cardiovascular intensive care unit (CVICU) staff and physicians are on hand to make sure everything is being done to help. But when other critical health issues arise, patients sometimes get moved to other intensive care units and away from the CVICU team that was there to help them from the beginning.
With this scenario in mind, cardiologists at UC Health University Hospital have teamed up with critical care physicians to create a collaborative CVICU team, improving patient outcomes and satisfaction.
Steven Lisco, MD, director of critical care in the department of anesthesiology and in the CVICU at University Hospital, says the benefit is simple: patient-focused, not hospital-focused, care.
"Patients get admitted to the CVICU because their primary problem is cardiac disease,” he says.
"With this collaboration, they’ll get all critical care needs met and still be able to stay in the unit where their admitting cardiologist is close at hand, rather than being transferred to another ICU with a whole new team and a different rounding cardiologist.
"Patients and their families form relationships with the doctors, nurses, pharmacists and physical therapists. In avoiding a move to a new unit, they don’t have to get reacquainted with a whole new care team.”
Critical care involves close, constant attention by a team of specially trained health professionals. Problems that might need critical care treatment include shock, infection, bleeding, accidents and severe breathing problems.
Anesthesiology has already teamed up with cardiology to perform pre-operative evaluations, helping to find and treat heart problems and optimize patient status prior to procedures requiring anesthesia.
"The recent collaboration offers consistency and communication among the care team,” Lisco says.
"We’re trying to define and strengthen the role of critical care on the unit and allow patients to get all of their needs met in the CVICU, without being transferred floor to floor.” He adds that this is helpful in facilitating patient flow in the hospital.
"It’s making the best decision for patients based on what a collaborative, interdisciplinary team defines as priorities of care instead of just admitting to a unit based simply on the bed availability,” he says.
Lisco says the main reason for this collaboration is to make sure that the real reason for the hospital stay is never forgotten and that the patients’ needs are met above all else.
"Of course we help manage consults with other specialists in conjunction with the cardiologist, but these patients find their way to the CVICU because of a heart issue,” he says.
"We want to make sure that doesn’t get put on the back burner just because other problems arise.”
And the collaboration doesn’t end with cardiology. The same anesthesia critical care team also provides care for patients undergoing cardiac, vascular and thoracic surgery.
"This allows for even greater continuity of care and a seamless process for the patients and their families,” says Neal Weintraub, MD, director of the division of cardiovascular diseases.
"In addition, training of students, residents and fellows from both departments is enhanced through this collaboration. Dr. Lisco and his team are outstanding teachers and play a vital role in critical care instruction for our trainees, which also include residents from the emergency department.”
In-House Critical Care Manager in the Works
In July, says Steven Lisco, MD, UC Health University Hospital will have a critical care attending physician within the hospital at all times, overseeing the numerous critical care teams on the floors.
"With someone in this role, we’ll be further increasing collaboration, communication and improving patient care,” he says.