The Leapfrog Group was created in 2000 by large companies in the US to improve healthcare quality. They recognized that quality required safety. A large step in that effort was implementing continuous Intensivist coverage in ICUs. Our group was started in 2001 to meet that need in Orange County.
Our group is exclusively contracted to provide 24 hour, 7 days a week coverage that exceeds the 8 hour on-site recommendations by Leapfrog.
This means that there is always a highly trained expert physician available to manage the sickest patients in the hospital.
Our team of Intensivists meets patients where they are - not just in the ICU. That also means reaching out to other areas of the hospital to recognize deteriorating conditions as early as possible. This improves outcomes by preventing dangerous decompensation and organ failure.
In 2002, SCCM issued the "Barcelona Declaration" which identified sepsis as the #10 cause of death. The goal was to reduce death from sepsis globally.
Locally, our group created a comprehensive sepsis program to identify, manage and treat sepsis as soon as possible. We created sepsis care checklists and a mobile app to help coordinate care for patients at risk of sepsis. This has resulted in faster recovery times and lower rates of death from sepsis.
Providing exceptional care requires close collaboration with doctors, nurses and respiratory therapists. Since the group's inception, we have worked closely with nursing colleagues in the formation of the rapid response team.
By identifying at risk patients and intercepting their declining health status, we are able to accurately identify patients who need higher levels of care and attempt to prevent worsening organ dysfunction. This improves patient safety and decreases risk of death for sick patients.
Our Intensivists actively participate in local process improvement projects and committees within the hospital to improve care. Our physicians provide ICU and medical staff leadership at Hoag Hospitals.
We work side by side with physicians and administration to identify areas of potential improvement resulting in superior patient care. Working together, we have worked to decrease central line bloodstream infection (CLABSI), catheter associate urinary tract infections (CAUTI), ventilator associated pneumonias (VAP) and hospital acquired infections.
When the more usual methods of life support fail, extracorporeal membrane oxygenation (ECMO) is able to support the heart and lungs and provide an opportunity for patient survival. Our group brought VV-ECMO to Orange County in 2016 to provide support for patients failing mechanical ventilation. This care has now expanded to VA-ECMO for patients need cardiac support.
Spearheaded by the Society of Critical Care Medicine (SCCM), the ICU Liberation Campaign's goal is to "liberate patients from the harmful effects of pain, agitation, sedation, delirium, immobility, and sleep disruption (PADIS) in the intensive care unit (ICU)."
By transforming ICU culture and decreasing use of sedatives and narcotics, patients experience less delirium and improved outcomes. Additionally, physical therapists work with patients early in their ICU course. Family engagement with the medical team in the care of their loved ones is encouraged. Combined, these efforts lead to improved outcomes with lessened long- and short-term consequences of an ICU stay.
Early goals of critical care medicine focused on survival and discharge from the hospital. Over the past decade, we have learned that ICU survivors continue to experience cognitive, emotional and physical symptoms and problems that persist for weeks to months after their ICU stay. The THRIVE initiative and creation of Post Critical Care Recovery clinics aim to help patients and their families learn about and treat these persistent problems.
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