Twenty-four hour presence of physicians in the ICU 英文参考文献.docVIP

Available online /content/5/3/131 Review Twenty-four hour presence of physicians in the ICU Hilmar Burchardi and Onnen Moerer Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Hospital G?ttingen, Germany Correspondence: Prof Dr Hilmar Burchardi, Zentrum Anaesthesiologie Rettungs- und Intensivmedizin, Klinikum der Georg-August-Universit?t, Robert- Koch-Str 40, D 37070 G?ttingen, Germany. Tel +49 551 39 6027; fax : +49 551 39 6530; e-mail: hburcha@gwdg.de Received: 18 April 2001 Accepted: 22 April 2001 Published: 2 May 2001 Critical Care 2001, 5:131–137 ? BioMed Central Ltd on behalf of the copyright holder (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Intensive-care units (ICUs) must be utilised in the most efficient way. Greater input of intensivists leads to better outcomes and more efficient use of resources. ‘Closed’ ICUs operate as functional units with a competent on-site team and their own management under the supervision of a full-time intensivist directly responsible for the treatment. Twenty-four-hour coverage by on-site physicians is mandatory to maintain the service. At night, the on-site physicians need not necessarily be specialists as long as an experienced intensivist is on call. Because of the shortage of intensivists, such standards will be difficult to maintain everywhere, but they should, at least, be mandatory for larger hospitals serving as regional centres. Keywords: 24-hour coverage critical care, intensive-care units, organisation and management, outcome and process assessment Introduction nate in Western Europe. Now there seems to be an increasing awareness in the USA that the closed ICU may be more efficient. Intensive-care units (ICUs) are the most expensive part of a hospital. It is therefore extremely important that they are used in the most efficient way. As in any other business, high quality and cost-effective performance in intens