Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong, People's Republic of China.
Intensive Care Med. 2010 Apr;36 Suppl 1(Suppl 1):S21-31. doi: 10.1007/s00134-010-1762-3.
To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on enhancing coordination and collaboration between the ICU and other key stakeholders.
Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including coordination and collaboration.
Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resource use and communications; (2) develop a system of communication, coordination and collaboration between the ICU and key interface departments within the hospital; (3) identify key functions or processes requiring coordination and collaboration, the most important of these being manpower and resources utilization (surge capacity) and re-allocation of personnel, equipment and physical space; (4) develop processes to allow smooth inter-departmental patient transfers; (5) creating systems and guidelines is not sufficient, it is important to: (a) identify the roles and responsibilities of key individuals necessary for the implementation of the guidelines; (b) ensure that these individuals are adequately trained and prepared to perform their roles; (c) ensure adequate equipment to allow key coordination and collaboration activities; (d) ensure an adequate physical environment to allow staff to properly implement guidelines; (6) trigger events for determining a crisis should be defined.
Judicious planning and adoption of protocols for coordination and collaboration with interface units are necessary to optimize outcomes during a pandemic.
为流感大流行或大规模灾害期间的重症监护病房(ICU)和医院准备提供建议和标准作业程序(SOP),特别关注增强 ICU 与其他关键利益相关者之间的协调与合作。
基于文献回顾和专家意见,采用德尔菲法定义了包括协调与合作在内的基本议题。
关键建议包括:(1)在设施、地方、区域/州或国家各级建立一个具有紧急执行控制小组的事件管理系统,以对资源使用和通信行使权力和指导;(2)在 ICU 和医院内部的关键接口部门之间建立一个沟通、协调和合作系统;(3)确定需要协调与合作的关键功能或流程,其中最重要的是人力和资源利用(扩充能力)以及人员、设备和物理空间的重新分配;(4)制定流程以实现部门间平稳的患者转科;(5)制定系统和指南是不够的,重要的是:(a)确定实施指南所需的关键个人的角色和责任;(b)确保这些个人得到充分的培训和准备以履行其角色;(c)确保有足够的设备以允许进行关键的协调和合作活动;(d)确保有足够的物理环境以允许员工正确实施指南;(6)应定义确定危机的触发事件。
明智的规划和采用与接口单位的协调与合作协议对于大流行期间的优化结果是必要的。