The intensive care unit (ICU) is a special hospital unit that handles cases of most injured and ill patients and requires continuous, close and persistence monitoring and support mechanisms from well-equipped health professionals in order to save their lives. Among the treatments offered in ICUs include sepsis, trauma, post surgical treatments, multiple-organ failure and acute respiratory diseases among others (Lanken, Hansen & Manaker, 2001). This paper pays high attention to the analysis of the capacity management challenge at the ICUs of Brigham and women`s hospital (BWH), and the measures that can be put in place in order to enhance the flow of patients in these hospital`s ICUs.
Most of the health physicians in that hospital failed to follow the established procedures due to ignorance, lack of adequate training and adherence to the patients` ICUs admission procedures. The hospital`s policy stipulates that, when the patient`s admitting floor contacts the physician in charge of the primary intensive care unit, it is the duty of the latter to contact the physician in charge of the secondary intensive care unit inquiring for a free bed if his or her unit does not have one. During that day, the MICU attending physician was supposed to contact the SICU attending physician but not ignoring that duty and instead delegate it to Mr. Dugar. In addition, the nurse administrator was not supposed to directly link Dr. Martin Zolo to the physician in the SICU since this is the role of the physician in charge of MICU (Tucker & Berry, 2010).
Failure to adhere to the established protocols of requesting ICU beds is disastrous. First, it can lead to blaming and enemity among the health professionals. For example, Dr. Dugar could have felt rejected for he requested an ICU bed before Dr. Zolo, but the latter managed to get one before him (Dr. Dugar) (Tucker & Berry, 2010). Secondly, it can result to death of the patients who require intense care due to unnecessary delays.
In exhibit six, the original email of Dr. Selwyn Rogers, that was sent on Monday, 10th march 2008, at 7.01 PM, was directed to the members of the Emergency Department (except Dr. Krishna Dugar), highlighting the problems that occurred in the process of requesting a bed in the hospital`s ICU. His comments were seconded two and a half hours later by an email from the nursing director, Anne Thompson, who claims that the problems arose due to non-compliance and knowledge deficit of the associated health professionals. She promises to determine areas that had the knowledge deficit. After 45 minutes, she sent a second email outlining the information she gathered from nurse administrators after her follow-up. The fourth email was sent at mid-day, Tuesday, 11th by Dr. Rogers, who admits that the whole scenario involved parallel processing and work-around. He finally sends the last email on that Saturday march 15th at 9.39 AM, emphasizing the purpose of his first email to those members who thought he intended to blame the emergency department (Tucker & Berry, 2010).
As a medical officer of BWH, identification of the causes of the problem and the health professionals who were responsible for their occurrence could be important. Then inquire from them why they acted that way, and brief them on the adverse effects that may result and after they admit their mistakes, I would give them a second chance after which I would fire those who would fail to comply (DeVita, Hillman & Bellomo, 2011).
Revising the protocols of admitting patients to the ICUs is necessary this hospital and should include minimizing the number of calls that health physicians are required to make while admitting patients so as reduce confusion. Secondly, sensitize health physicians to comply with the established protocols of admitting patients to the ICU in order to minimize or avoid unnecessary delays in admitting patients. Third, the health professionals should regularly undergo training in order to adequately equip them with skills of admitting patients, and providing notifications concerning potential ICU patients (Gullo & Lumb, 2005).
DeVita, M. A., Hillman, K., & Bellomo, R. (2011). Textbook of rapid response systems: Concept and implementation. New York: Springer.
Gullo, A., & Lumb, P. D. (2005). Intensive and critical care medicine: Reflections, recommendations, and perspectives. Milan: Springer.
Lanken, P. N., Hansen, C. W., & Manaker, S. (2001). The intensive care unit manual. London: W. B. Saunders.
Tucker A., L., & Berry J., A., (2010). Patient Flow at Brigham and Women’s Hospital (A). Harvard Business School Publishing, Boston.
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