title: Protocols in the management of critical illness.
abstract: Care of the critically ill patient is becoming increasingly complex. Protocols, which standardize care of patients with similar diseases, represent a potential solution to managing multiple simultaneous problems in critically ill patients. In this article, we examine the advantages and disadvantages to care protocolization, and posit that careful and thoughtful implementation of protocols is likely to benefit patients. We also discuss the potential for unintended consequences, and even harm, with protocolization in critically ill patients using the Critical Illness Outcomes Study as a model to examine the effects of protocolization in large populations of intensive care patients.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Medicine and Dentistry of New Jersey - New Jersey Medical School, 150 Bergen St, UH-I354, Newark, NJ 07103, USA. changsy@umdnj.edu
authors.forename: Steven Y
authors.initials: SY
authors.lastname: Chang
authors.forename: Jon
authors.initials: J
authors.lastname: Sevransky
authors.forename: Greg S
authors.initials: GS
authors.lastname: Martin
mesh_terms: D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods* / Q000639:trends; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D019468:Disease Management; D006801:Humans