Chapter 33. ICU Guidelines, Best Practices, and Standardization

Arthur P Wheeler, MD, FCCP
DOI: 10.1378/critcare.21.33
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  • Appreciate the role of the intensivist in ICU organization.

  • Learn basics of ICU organizational structure.

  • Learn important common practices that benefit from protocolization.

  • Understand the importance of multi-disciplinary rounds.


A successful ICU balances three inextricably linked factors: quality of care, efficiency, and cost control. Although increasing resource utilization often does not lead to improved quality, inefficiency almost always hurts quality. Along the same lines, in most cases improving quality reduces resource utilization and costs while improving efficiency. Typically such savings are achieved by reducing length of stay, preventing complications and readmissions, limiting ineffective or excessive care, reducing staff turnover, and reducing complaints and litigation.


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