title: Centralized triage for multiple intensive care units: the central intensivist physician.
abstract: Subspecialization of critical care units and overall increasing demand for critical care services has led to inefficiencies in allocation of critical care resources with potential impacts on hospital economics and patient outcomes. Centralized management of critical care resource allocation within an institution may improve use while simultaneously ensuring quality of patient care. The authors' institution has implemented a Central Intensivist Physician (CIP) program to oversee resource allocation within the adult surgical intensive care units (ICUs). The result has been an improvement in patient flow throughout the surgical ICUs manifested by steady case cancellation rates despite increasing acuity and length of stay. Additionally, triage duties have been shifted from the individual unit physician to the CIP, resulting in improved provider satisfaction from improved continuity of rounds. The authors conclude that the CIP program may improve overall critical care resource use while maintaining unit specialization within a large tertiary care hospital setting.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. mromig1@jhmi.edu
authors.forename: Mark
authors.initials: M
authors.lastname: Romig
authors.forename: Asad
authors.initials: A
authors.lastname: Latif
authors.forename: Peter
authors.initials: P
authors.lastname: Pronovost
authors.forename: Adam
authors.initials: A
authors.lastname: Sapirstein
mesh_terms: D002497:Centralized Hospital Services; D006295:Health Resources; D006801:Humans; D007362:Intensive Care Units; D009936:Organizational Innovation; D010820:Physicians; D013503:Surgery Department, Hospital; D014218:Triage / Q000458:organization & administration*