Dr. Rohit Uppal is TeamHealth’s chief clinical officer for hospitalist services. In this capacity, he works with TeamHealth clinicians and senior operational leaders as well as hospital and health system administrators across the country to develop and implement protocols and pathways that improve efficiency, clinical quality and patient safety.
Opportunities for ICU improvement in a post-pandemic world
COVID-19's spotlight on critical care brings program excellency into focus
RU: The pandemic put huge strains on intensivists and critical care units across the country. Interestingly, the very elements that make our programs successful were the keys to our critical care COVID response. Our national platform allowed us to leverage resources and expertise. Our culture of collaboration and alignment with our hospital partners allowed us to be flexible and identify/share best practices across the country to ensure best in class performance. Our strength in leadership meant that our hospital partners had a solid medical staff leader in place to champion the local COVID response.
Early on, PPE shortages were a threat to the safety of our intensivists. We were able to leverage our supply chain management resources to secure PPE and deliver it to our clinicians in the field. Another early challenge was the paucity of clinical guidelines. TeamHealth’s Emerging Infectious Diseases Task Force began meeting in January, bringing national and even international experts together to evaluate data and make recommendations. The next challenge we faced was the uneven nature of the pandemic. We were able to redistribute our workforce to ensure that hot spots had the resources needed. Our clinicians actually ended up delivering our critical care services at several hospitals where we were not even contracted to staff their ICU.
RU: Clinician wellness and resiliency are major issues. During the pandemic we focused significant resources on the mental health of our intensivists. We did wellness calls. We leaned on our behavioral health colleagues to hold sessions with clinicians and teams. After the pandemic, we will need to continue these efforts. Our intensive care leaders are the key to our programs. They set the tone and the culture. They ensure that clinicians feel supported and that the practice environment in optimized. This is the highest priority.
Of course, challenges associated with throughput and capacity never go away. We find that most hospitals have significant opportunities to improve processes such as admission and discharge criteria, evidence-based practices to reduce ventilator days as well as establishing a framework for communication and coordination among emergency medicine, hospital medicine, surgeons and other specialists.
RU: Intensivists manage the sickest patients in the hospital and collaborate with almost every hospital department and every specialty. On that basis alone, they have a unique position of leadership among the medical staff.
Intensivists must also establish effective collaboration and communication with multiple specialists. We integrate with emergency medicine to manage ED throughput and timeliness of care and to aggressively manage patients suffering with sepsis, stroke, myocardial infarction and other conditions. We partner with hospitalists to ensure seamless handoffs, reduce hospital acquired conditions and support hospitalists with rapid response, codes and procedures.
RU: A major benefit to our hospital partners is TeamHealth’s ability to recruit and retain highly skilled intensivists. We have a world-class recruiting team with a national footprint. We have a dedicated residency recruitment team that maintains relationships inside critical care fellowships. And of course, once we bring in an intensivist, we provide him or her a supportive practice environment and opportunities for growth and development.
To learn more, visit teamhealth.com/criticalcare.