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Year in review 2011: Critical Care - Resource Management

机译:年度回顾:2011年:重症监护-资源管理

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摘要

Increasing complexity and costs are a fundamental problem in critical care medicine, leading researchers to study opportunities and threats to continue to provide high-quality care in a more efficient health system. Over the past decades, we have learned from industrial methods that quality improvement and resource management can help achieve these results. Last year, Critical Care published a number of papers that highlight key points of critical care resource management. Each of these is grouped into one of three broad categories, based on domains of quality: (a) outcomes, in which we review long-term outcome data with an emphasis on the aging population, strategies to help mitigate the psychological burden of critical care, adverse events, and the appropriate use of resources, such as prolonged mechanical ventilation and intensive care unit (ICU) beds; (b) processes of care, in which we review variability in the provision of critical care, owing to gender, insurance status, and delays in ICU admission; knowledge translation studies in critical care; goal-directed therapy for postoperative patients and decision-making in the ICU; and (c) structure, in which we review strategies to improve quality through changes in design and the structural limitations to provide care in resource-limited settings.
机译:日益增加的复杂性和成本是重症监护医学的基本问题,导致研究人员研究机会和威胁,以继续在更有效的卫生系统中提供高质量的护理。在过去的几十年中,我们从工业方法中学到了质量改进和资源管理可以帮助实现这些结果。去年,重症监护室发表了许多论文,重点介绍了重症监护资源管理的关键点。根据质量范围,将这些分类为以下三大类之一:(a)结果,在此我们回顾了以人口老龄化为重点的长期结果数据,以帮助减轻重症监护的心理负担的策略,不良事件和适当的资源使用,例如长时间的机械通气和重症监护病房(ICU)病床; (b)照护过程,在该过程中,我们审查了由于性别,保险状况和重症监护病房入院延误造成的重症监护服务的差异性;重症监护中的知识翻译研究;术后患者的目标导向治疗和ICU中的决策; (c)结构,其中我们回顾了通过更改设计和结构限制来提高质量的策略,以便在资源有限的环境中提供护理。

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