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May 13, 2014 > Washington Hospital's Multidisciplinary Approach Saves Lives

Washington Hospital's Multidisciplinary Approach Saves Lives

Recognition Month Honors Critical Care Specialists

If you are facing a life-threatening event, who would care for you when you arrived at the hospital? Who would be there to ensure that you received the life-saving treatments you needed? Nearly 80 percent of us will be affected by a life-threatening illness or injury in our lifetime, according to the Society of Critical Care Medicine.
"The most gravely ill patients are treated by critical care specialists," said Dr. Carmencita Agcaoili, a critical care pulmonologist and medical director of the Intensivist Program at Washington Hospital. "During Critical Care Awareness Month in May, we recognize the contributions of these specially trained healthcare professionals."
Washington Hospital is on the leading edge of critical care medicine. The hospital launched its Intensivist Program in 2008 and now has nine intensivists who are part of the medical staff. It is one of the few hospitals in the Bay Area with an intensivist available 24 hours a day, seven days a week.
Intensivists are physicians who direct and provide medical care for patients in the intensive care unit (ICU), where critically ill patients are treated. They are board-certified in critical care medicine and in a primary specialty such as internal medicine, surgery, anesthesiology, or pediatrics.
Intensivists work with the attending physician and other members of the critical care team such as critical care nurses, pharmacists, respiratory therapists, nutritionists, rehabilitation services, social workers, case managers, and physician specialists as well as spiritual care staff and volunteers. The team works together to ensure the patient is getting the best care possible.
In addition, Washington Hospital recently started a Neurocritical Care Program with board-certified neurointensivists. This specialty within critical care medicine is focused on devastating brain injuries.
"That could include a devastating brain hemorrhage due to a ruptured brain aneurysm, brain tumor, a major head trauma or spinal cord injury from an accident or any other illness or injury that affects the brain," Dr. Agcaoili explained. "Neurointensivists are an important part of the critical care team."
Washington Hospital's multidisciplinary approach has been proven to saves lives. A 2010 study published in the Archives of Internal Medicine found that the death rate among patients was lowest at hospitals that use this type of multidisciplinary team led by a trained intensivist.
Right Care, Right Now
"The goal of critical care medicine is to provide the right care, right now," Dr. Agcaoili said. "Everything we do is time sensitive, but it also has to be the right care. That's why it's so important to have a team of specialists who can provide the right care at any given moment."
Washington Hospital is focused on getting people up and moving as soon as possible and reducing the incidence of delirium among patients in the ICU. Delirium is a state of confusion that can come on rapidly and is common among ICU patient, according to Dr. Agcaoili.
"We are working on an early mobility project aimed at getting ICU patients up and moving as soon as possible," she said. "Before we used to just let them sleep until they were off the ventilator. Now we assess whether we can wake them up, even if they are still on the ventilator, and get them moving. Early mobility has been shown to reduce delirium as well as the length of time on the ventilator and in the hospital. Immobility can cause problems. After just two days of being immobile, you can lose up to 10 percent of your muscle strength."
She said patients' loved ones also play an important role in patients' care and recovery. A life-threatening illness or injury can have a serious impact on them. Washington Hospital's Family Assistance Program addresses the needs of critical care patients and their families.
"When a patient comes in, we want to make sure we are taking care of them and their family," Agcaoili said. "We started a new project where we give families a small notebook where they can keep a diary and write down what is happening to the patient. It's important for them to be involved. They play a big role in a patient's recovery. Washington hospital not only offers state-of-the art critical care medicine, but also patient and family-centered care."
For more information about Washington Hospital's Intensivist Program, visit

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