title: The Cardiovascular Intensive Care Unit-An Evolving Model for Health Care Delivery.
abstract: Prior to the advent of the coronary care unit (CCU), patients having an acute myocardial infarction (AMI) were managed on the general medicine wards with reported mortality rates of greater than 30%. The first CCUs are believed to be responsible for reducing mortality attributed to AMI by as much as 40%. This drastic improvement can be attributed to both advances in medical technology and in the process of health care delivery. Evolving considerably since the 1960s, the CCU is now more appropriately labeled as a cardiac intensive care unit (CICU) and represents a comprehensive system designed for the care of patients with an array of advanced cardiovascular disease, an entity that reaches far beyond its early association with AMI. Grouping of patients by diagnosis to a common physical space, dedicated teams of health care providers, as well as the development and implementation of evidence-based treatment algorithms have resulted in the delivery of safer, more efficient care, and most importantly better patient outcomes. The CICU serves as a platform for an integrated, team-based patient care delivery system that addresses a broad spectrum of patient needs. Lessons learned from this model can be broadly applied to address the urgent need to improve outcomes and efficiency in a variety of health care settings.
authors.affiliation: 1 Division of Cardiovascular Medicine, University of Louisville, Jewish Hospital/Kentucky One Health, Louisville, KY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Loughran
authors.affiliation: 2 Division of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Tauqir
authors.initials: T
authors.lastname: Puthawala
authors.affiliation: 1 Division of Cardiovascular Medicine, University of Louisville, Jewish Hospital/Kentucky One Health, Louisville, KY, USA.
authors.forename: Brad S
authors.initials: BS
authors.lastname: Sutton
authors.affiliation: 1 Division of Cardiovascular Medicine, University of Louisville, Jewish Hospital/Kentucky One Health, Louisville, KY, USA.
authors.forename: Lorrel E
authors.initials: LE
authors.lastname: Brown
authors.affiliation: 3 Departments of Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.|4 Department of Health Policy & Management, The Bloomberg School of Public Health, Baltimore, MD, USA.|5 School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.affiliation: 1 Division of Cardiovascular Medicine, University of Louisville, Jewish Hospital/Kentucky One Health, Louisville, KY, USA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: DeFilippis
mesh_terms: D003325:Coronary Care Units / Q000458:organization & administration* / Q000592:standards; D064648:Critical Care Nursing; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000639:trends; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D012151:Resuscitation / Q000379:methods*; D013686:Telemetry; D015912:Thrombolytic Therapy / Q000379:methods*
keywords: acute myocardial infarction; cardiovascular intensive care unit; coronary care unit; health care delivery methods; science of health care delivery