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Critical Care Medicine

An intensive care or critical care unit is a patient care unit dedicated to treating patients who are critically ill by staff specially trained to administer care to acutely ill patients.  In these units there is continuous nursing, medical supervision and monitoring to ensure that patients get the high level of care and attention they need. 

 

 

The Intensive Care Units (ICU) at Baystate Medical Center (BMC) are staffed by dedicated critical care trained physicians, known as intensivists.  This staffing model was in place at BMC long before the model became a national recommendation in the Leapfrog initiative of 1999, and ensures delivery of safe, appropriate care.

 

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  • The Adult ICU at BMC admits patients with a very high severity of illness.  Our current observed hospital mortality rate is 18.61% versus an expected hospital mortality rate of 23.74%.  The result is an SMR (standardized mortality ratio) of 0.79.  An SMR below 1.0 indicates fewer patients died than expected.

 

  • Our ICU length of stay (LOS) is 3.44 days versus 5.06 days in similar hospitals, resulting in a LOS ratio of 0.68.  LOS ratios below 1.0 indicate patients stay in the ICU for a shorter time than they are expected.  This is a marker for getting the right care to patients sooner so they get better faster.

 

  • The BMC ICU has always been an early adopter of evidence-based practices to improve patient outcomes.  Careful attention is paid to reliably applying the ventilator care bundle, including  head-of-bed elevation, a daily sedation “vacation,” peptic ulcer and deep venous thrombosis prophylaxis, glycemic control, and frequent mouth/oral care to prevent ventilator-associated pneumonia (VAP).

 

  • The ICU continues to use an electronic checklist to support the application of all known evidence-based practices and to identify any patients where all safety measures are not yet in place.  Compliance with recommended ICU safety measures is nearly 100%.  This has resulted in significant year-to-year decreases in both ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI).

 

  • BMC’s Adult ICU is a five-time recipient of the Beacon Award for critical care excellence and is the only ICU in the country to achieve this distinction.  We attribute these excellent results to our multidisciplinary model of patient care, extensive use of protocols, high level of computerization (100% computerized provider order entry) which allows for drug dose-range checking, numerous clinical alerts and reminders, and plan of care modification based on organ system dysfunction.

 

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  • BFMC received the highest honor at the annual Baystate Health President's Quality Award for their work "Implementing Multi-Disciplinary Rounds," which appropriately reduced length of stay while increasing quality of care and communication.

 

  • The Critical Care service line team meets monthly to engage staff in best practice and to monitor data related to several quality indicators, such as results of code blues.

 

  • BFMC adopted early sepsis identification and will be implementing the electronic early warning system for sepsis which is based on data in the clinical record.

 

For more information on Quality at Baystate Health

For more information on Baystate Medical Center 

For more information on Baystate Franklin Medical Center

For more information on Baystate Mary Lane Hospital