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Managing intensive care units: Make LOVE,not war!
Authors:Jean Carlet  Maité Garrouste-Orgeas  Marie-Françoise Dumay  Fredérique Diaw  Bertrand Guidet  Jean-François Timsit  Benoit Misset
Institution:1. Groupe Hospitalier Paris Saint-Joseph, Réanimation Polyvalente, 75014 Paris, France;2. Hôpital Saint-Antoine, Réanimation Médicale, 75012, and INSERM U 707, Paris, France;3. CHU Hôpital Albert Michallon, Réanimation Médicale, BP 217 38043 Grenoble CEDEX 9, France;4. Inserm U 823 Grenoble, France;5. Université Paris Descartes
Abstract:

Objective

Describe a program set up in a French intensive care unit (ICU) aimed at improving communication inside the team and communication information given to patients and their relatives; explain how those actions can improve communication inside the ICU and ultimately why it could improve patient's outcome.

Design and Methods

Position paper.

Intervention

Progressive implementation of multifaceted quality improvement program.

Results

The program Leadership, Ownership, Values, and Evaluation (LOVE) was developed over 10 years. It was usually well accepted by the members of the team, patients, and relatives, in particular the 24-hour visiting program that was prospectively evaluated. Information and decisions were shared with the patients or more often with the relatives, who became for some of them really “part of the team.” Additional actions such as participation to some of the simplest cares by the families are under investigation. A prospective evaluation of such programs, although difficult to perform, remains probably necessary.

Conclusion

Quality of life within the ICU is based on many factors including a strong and positive leadership, an absolute respect of individuals, and a rigorous evaluation of quality of care, which could influence heavily the quality of life in the ICU for patients, relatives, and health care professionals and facilitate team work. Whether this could really influence outcome remains to be demonstrated.
Keywords:Leadership  Organization  Culture  Clinical governance  Love  Evaluation  Intensive care unit
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