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Erratum
- Major Obstacles to Implement a Full-Time Intensivist in Korean Adult ICUs: a Questionnaire Survey
- Jun Wan Lee, Jae Young Moon, Seok Wha Youn, Yong Sup Shin, Sang Il Park, Dong Chan Kim, Younsuk Koh
- Korean J Crit Care Med. 2016;31(3):262-262. Published online August 30, 2016
- DOI: https://doi.org/10.4266/kjccm.2016.31.2.111.e01
- Corrects: Acute Crit Care 2016;31(2):111
- 4,926 View
- 80 Download
- 1 Crossref
Original Articles
- Policy
- Major Obstacles to Implement a Full-Time Intensivist in Korean Adult ICUs: a Questionnaire Survey
- Jun Wan Lee, Jae Young Moon, Seok Wha Youn, Yong Sup Shin, Sang Il Park, Dong Chan Kim, Younsuk Koh
- Korean J Crit Care Med. 2016;31(2):111-117. Published online May 31, 2016
- DOI: https://doi.org/10.4266/kjccm.2016.31.2.111
- Correction in: Acute Crit Care 2016;31(3):262
- 8,361 View
- 113 Download
- 3 Crossref
-
Abstract
PDF - Background:
Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea.
Methods
An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS).
Results
Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues.
Conclusions
Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist’s role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers. -
Citations
Citations to this article as recorded by
- Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study
Jaeyoung Choi, Esther Park, Ah Young Choi, Meong Hi Son, Joongbum Cho
Journal of Korean Medical Science.2023;[Epub] CrossRef - Willingness to pay for family education and counselling services provided by critical care advanced practice nurses
Chung Mee Ko, Chin Kang Koh, Sangho Kwon
International Journal of Nursing Practice.2019;[Epub] CrossRef - Intensivist as a Surgeon: The Role of a Surgeon in Critical Care Medicine
Kyung Sook Hong
The Ewha Medical Journal.2017; 40(2): 61. CrossRef
- Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study
- Pulmonary
- The Usefulness of Intensivist-Performed Bedside Drainage of Pleural Effusion via Ultrasound-Guided Pigtail Catheter
- Joo Won Min, Joon Young Ohm, Byung Seok Shin, Jun Wan Lee, Sang Il Park, Seok Hwa Yoon, Yong Sup Shin, Dong Il Park, Chaeuk Chung, Jae Young Moon
- Korean J Crit Care Med. 2014;29(3):177-182. Published online August 31, 2014
- DOI: https://doi.org/10.4266/kjccm.2014.29.3.177
- 4,699 View
- 46 Download
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Abstract
PDF
- BACKGROUND
There has been little data reporting the usefulness of intensivist-performed bedside drainage of pleural effusion via ultrasound (US)-guided pigtail catheter. The objective of this study is to clarify the usefulness and safety of these methods in comparison with radiologist-performed procedures.
METHODS
Data of patients with pleural effusion treated with US-guided pigtail catheter drainage were analyzed. All procedures were performed from September 2012 to September. 2013 by a well-trained intensivist or radiologist.
RESULTS
Pleural effusion was drained in 25 patients in 33 sessions. A radiologist performed 21 sessions, and an intensivist performed 12 sessions. Procedures during mechanical ventilation were performed in 15 (71.4%) patients by a radiologist and in 10 (83.3%) by an intensivist (p = 0.678). The success rate was not significantly different in radiologist- and intensivist-performed procedures, 95.2% (20/21) and 83.3% (10/12), respectively (p = 0.538). The average duration for procedures (including in-hospital transfer) was longer in radiologist-performed cases (p = 0.001). Although the results are limited because of the small population size, aggravation of oxygenation, CO2 retention, and decrease of mean arterial blood pressure were not statistically different in the groups. Pigtail-associated complications including hemothorax, pneumothorax, hepatic perforation, empyema, kink in the catheter, and subcutaneous hematoma were not found.
CONCLUSIONS
Intensivist-performed bedside drainage of pleural effusion via ultrasound (US)-guided pigtail catheter is useful and safe and may be recommended in some patients in an intensive care unit.
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