FEBRUARY
2005
Volume 29 •
No. 2
Medical
Staff Update Cover Story:
Deadline
for ICU credentialing approaches
Physicians must complete ICU credentialing by an April 1 deadline if they wish to serve as an attending physician or consultant in an ICU under a policy adopted by the Medical Board last April.
The criteria for critical care credentialing include:
Board certification or eligibility in the subspecialty of critical care medicine
OR:
The Critical Care Committee will both grant initial credentials and review each intensivist's credentials every two years, according to the Medical Board policy ratified by the Board of Hospital Directors last year.
Core privileges include maintenance of open airway, oral/nasal intubation, ventilator management, insertion and management of chest tubes; placement of arterial, central venous and pulmonary artery balloon flotation catheters; and calibration and operation of hemodynamic monitoring systems.
The credentialed critical care physician, or intensivist "can either be the attending of record or can be in a consultative role of the attending of record," according to the policy, which was prompted by research showing - among other benefits -a 30 percent reduction in ICU mortality in general medical surgical ICUs when intensivists manage the patients.
A systematic review published in the Nov. 6, 2002 issue of the Journal of the American Medical Association demonstrated that care by intensivists is associated with reduced hospital and ICU mortality, as well as overall hospital and ICU length of stay. Moreover, the intensivist model has become the norm in other nations, including England and Australia, and is increasingly becoming the standard of care in the United States, according to the review entitled Physician Staffing Patterns and Clinical Outcomes in Critically Ill Patients.
Norman Rizk, director of intensive care units, stressed that the policy, which applies to all ICU units at SHC, was explicitly not intended to exclude non-ICU attending physicians from maintaining continuity with their patients.
"In no way will this policy exclude any physicians from contributing to the care of their patients in ICUs," Rizk has said. The policy "simply guarantees that an experienced physician trained in critical care will also be part of the picture."
Rizk noted that the need for critical care credentialing was driven in part by "the rapid expansion of technology, including newer ventilator modes, bedside ultrasound devices, etc."
He noted that third party payors and credentialing organizations are increasingly looking to a credentialed intensivist model as the norm in U.S. hospitals.
Deadline for ICU credentialing approaches
Marsh survey - CEO conducts Gallup poll, dialogue with employees
Remembrance and aid offered to Tsunami victims
'State of the School' addressed
PAWS isn't only for patients ...
