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Aurora BayCare providing higher level of care

Monday, November 26, 2001

Intensivists improve patient outcomes in ICU

GREEN BAY, Wis., Aurora BayCare Medical Center patients are benefitting from a new wave of patient care that evolved from hospital safety debates over the last two years.

Every intensive care patient who is admitted at Aurora BayCare Medical Center is seen by an intensivist, a physician with special training in intensive care medicine. It's the only hospital in the area with such a protocol for its ICU patients.

The difference is notable because national studies show that ICUs with intensivists available on short notice 24 hours a day - like the one at Aurora BayCare - have fewer deaths, shorter hospital stays and reduced costs. One study1 estimates that more than 50,000 lives would be saved in the United States each year if all hospitals used full-time intensivists. Another study showed that dedicated intensivists prevented or lessened post-surgical complications, decreased cardiac arrests and reduced infections.

Despite the studies, it's estimated that only 10 to 15 percent of the nation's hospitals require intensivist care for all ICU patients.

"We have to remember that ICUs developed in the 1960s as a way of focusing specialized medical attention on a hospital's sickest patients," said Cory Vogel, one of the hospital's three intensivists. "We then developed a nursing staff that was more comfortable working with those patients, but it took many years to create a physician staff dedicated to those patients."

Traditionally, hospitals have open ICUs where any physician can apply for privileges and care for patients. Intensivists at those hospitals served as consultants on especially difficult cases.

Aurora BayCare Medical Center has a semi-closed ICU which requires that every patient is seen by an intensivist. The patient's surgeon or other physician is also involved in determining the care pattern.

"With our training and current ICU staffing model, we have become familiar with critically ill patients and are better equipped to predict and treat complications which may occur with these patients," Dr. Vogel said.

Adding to the difficulty is a shortage of intensivists, with an estimated 6,500 in practice nationally. Many intensivists are also trained in another specialty such as surgery or internal medicine. Dr. Vogel, for example, also works in the hospital's Emergency Department - but not when it is his week to staff the ICU.

"Our only responsibility those weeks is covering the ICU," Dr. Vogel said. "We're not seeing clinic patients or in surgery. We are just in the ICU focusing all of our attention on those patients."

Aurora BayCare Medical Center has 24 ICU beds across two floors. The private rooms feature the highest level of critical care technology available. In addition to Vogel, the ICU is staffed by intensivists Raul Mendoza and Carlos Alvarado.

Aurora BayCare Medical Center is a joint venture of Aurora Health Care and BayCare Clinic. Aurora Health Care is a community-owned Wisconsin health care provider and a nationally recognized leader in efforts to improve the quality of health care. Aurora has care sites in 70 communities throughout eastern Wisconsin. BayCare Clinic comprises more than 75 physicians representing 18 medical and surgical specialties. As northeastern Wisconsin's largest independent physician-owned organization, BayCare is dedicated to providing patient choice and high quality care.

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