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J Acute Care Surg > Volume 11(3); 2021 > Article
Journal of Acute Care Surgery 2021;11(3):102-107.
DOI: https://doi.org/10.17479/jacs.2021.11.3.102    Published online November 23, 2021.
Analysis of Medical Consultation Patterns in Medical and Surgical Intensive Care Units: Changes in the Pattern of Consultation after the Implementation of Intensivist-Directed Care
Min-Jung Bang1  , So-Kyung Yoon1  , Kyoung Won Yoon1  , Eunmi Gil1,2  , Keesang Yoo1  , Kyoung Jin Choi1  , Chi-Min Park1,2 
1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence:  Chi-Min Park,
Email: dr99.park@samsung.com
Received: 23 October 2020   • Revised: 8 November 2020   • Accepted: 10 November 2020
Abstract
Purpose
Critically ill patients often require multidisciplinary treatment for both acute illnesses and pre-existing medical conditions. Since different medical conditions are managed in the intensive care unit (ICU), consultation is often required. This study aimed to identify the frequency and type of consultation required and analyze changes in consultation patterns after the introduction of intensivist-directed care in the surgical ICU (SICU).
Methods
Between June 2006 and December 2013, a retrospective cohort study was conducted to identify the frequency and type of consultation at 3 different ICUs. Consultations for patients who were admitted to the ICUs for more than 48 consecutive hours were included. The pattern of consultations in each ICU was investigated. In addition, the pattern of consultations before and after the implementation of intensivist-directed care in the SICU was compared.
Results
During the study, 11,053 consultations were requested for 7,774 critically ill patients in a total of 3 ICUs. Consultations with the Departments of Cardiology, Infectious Diseases, and Pulmonology were requested most frequently in the SICU. However, after the implementation of the intensivist-directed care approach, there was an increase in the frequency of consultation requests to the Department of Neurology, followed by the Departments of Cardiology, and Infectious Diseases.
Conclusion
Analysis of consultation patterns is an important method of assessing the complexity and severity of illnesses, and of evaluating the needs of available health system resources. Based on our findings, we suggest the development of an appropriate protocol for frequently consulted services.
Key Words: consultation, critical care, critical illness, intensive care units, physician
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