Management strategies to effect change in intensive care units: Lessons from the world of business - Part III. Effectively effecting and sustaining change

Hayley B. Gershengorn, Robert Kocher, Phillip Factor

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Reaping the optimal rewards from any quality improvement project mandates sustainability after the initial implementation. In Part III of this three-part ATS Seminars series, we discuss strategies to create a culture for change, improve cooperation and interaction between multidisciplinary teams of clinicians, and position the intensive care unit (ICU) optimally within the hospital environment. Coaches are used throughout other industries to help professionals assess and continually improve upon their practice; use of this strategy is as of yet infrequent in health care, butwould be easily transferable and potentially beneficial to ICU managers and clinicians alike. Similarly, activities focused on improving teamwork are commonplace outside of health care. Simulation training and classroom education about key components of successful team functioning are known to result in improvements. In addition to creating anICUenvironment in which individuals and teams of clinicians perform well, ICU managers must position the ICU to function well within the hospital system. It is important to move away from the notion of a standalone ("siloed") ICUto one that is well integrated into the rest of the institution. Creating a " pull-system" (in which participants are active in searching out needed resources and admitting patients) can help ICU managers both provide better care for the critically ill and strengthen relationships with non-ICU staff. Although not necessary, there is potential upside to creating a unified critical care service to assist with achieving these ends.

Original languageEnglish (US)
Pages (from-to)454-457
Number of pages4
JournalAnnals of the American Thoracic Society
Volume11
Issue number3
DOIs
StatePublished - Mar 2014

Keywords

  • Organization and administration
  • Program sustainability
  • Quality improvement

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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