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Salon a 17 kasim 2011 11.30 12.30 edgar j. jimenez
- 1. International Variations in ICU Resources WFSICCM Perspective Edgar Jimenez, MD, FCCM President World Federation of Societies of Intensive and Critical Care Medicine 8th National Congress Turkish Society of Medical and Surgical Intensive Care Medicine Ankara, November 2011
- 2. International Variations in ICU Resources WFSICCM Perspective Edgar Jimenez, MD, FCCM President World Federation of Societies of Intensive and Critical Care Medicine 8th National Congress Turkish Society of Medical and Surgical Intensive Care Medicine Ankara, November 2011
- 3. A Critical Care World Without Borders The “World Presence®” Initiative Edgar Jimenez, MD, FCCM President World Federation of Societies of Intensive and Critical Care Medicine 8th National Congress Turkish Society of Medical and Surgical Intensive Care Medicine Ankara, November 2011
- 4. Objectives • Burden of Critical Illness – Sepsis • Brief description of the World Federation • Describe World Presence ® • Describe VITAL CARE® • The ARGUS® Project
- 5. Challenges
- 6. IOM: Process Redesign “Health care has safety and quality problems because it relies on outmoded systems of work. If we want safer, higher-quality care, we will need to have redesigned systems of care”. The Institute of Medicine Report Crossing the Quality Chasm, 2001
- 7. IOM: Process Redesign “Health care has safety and quality problems because it relies on outmoded systems of work. If we want safer, higher-quality care, we will need to have redesigned systems of care”. The Institute of Medicine Report Crossing the Quality Chasm, 2001
- 8. IOM: Process Redesign “Health care has safety and quality problems because it relies on outmoded systems of work. If we want safer, higher-quality care, we will need to have redesigned systems of care”. The Institute of Medicine Report Crossing the Quality Chasm, 2001
- 9. WE have a problem!
- 10. Not all ICU’s are the same
- 11. Not all ICU’s are the same And they will NEVER be the same!!!
- 12. Estimated Life expectancy Source: CIA World Factbook: 2008
- 14. Public Health Expenditure Mortality 1-4 year old Source: www. worldmapper.com
- 15. Maternal mortality ratio* (WHO systematic review) Iceland 0 Canada 3 Germany 4 Australia 4 USA 9 UK 13 Malaysia 28 Mexico 64 RSA 150 Brazil 161 India 540 Kenia 414 Angola 502 Mali 582 Ruanda 1071 Malawi 1120 Bertran et al, BMC Public Health 2005 * deaths per 100,000 live births
- 16. Life Expectancy at Birth Source: WHO Fowler et al. Critical Care 2008, 12:225
- 17. Life Expectancy at Birth Source: WHO Fowler et al. Critical Care 2008, 12:225
- 18. Life Expectancy at Birth Source: WHO Fowler et al. Critical Care 2008, 12:225
- 19. Wish List 90 80 70 60 50 40 30 20 10 0 Monitoring Education Laboratory Drug supply ICU Staff Percent (%) Dünser et al. J Crit Care 2009, 24:469
- 20. Current Concerns • Limited bed availability • Lacking quality initiatives, best-practices (bundles) • Appropriate bed utilization – Lack of adequate referrals (Tiered) – Specialist availability – Futile care • Safe hand-off – Information mis-transfers – Medication reconciliation • ICU Nurse preparation/education/availability • ICU care coordinated by non-intensivist • Limited equipment resources
- 21. WFSICCM World Federation of Societies of Intensive and Critical Care Medicine
- 22. World Federation • In 2010 WFSICCM represents 60 countries • Total estimated membership is 136,000 + • Electronic access to > 13,000 ICUs
- 23. Countries Represented • Argentina • Australia • Austria • Bangladesh • Belgium • Belize • Bolivia • Brazil • Canada • Chile • Colombia • Costa Rica • Czech Republic • Ecuador • Egypt • El Salvador • Finland • France • Germany • Hong Kong • Hungary • India • Indonesia • IPACCMS • Ireland • Israel • Italy • Japan • Korea • Latvia • Lebanon • Macedonia • Mexico • Mongolia • Netherlands • New Zealand • Norway • Pakistan • Panama • Peru • Philippines • Portugal • PR China • Romania • Russia • Saudi Arabia • Singapore • Slovak Republic • Slovenia • South Africa • Spain • Sudan • Sweden • Switzerland • Turkey • United Arab Emirates • Uruguay • USA • Venezuela
- 24. WFSICCM’s World
- 25. WFSICCM’s Council 18 Seats
- 26. World Council • Belgium • Brazil • Canada • Chile • Colombia • France • Germany • India • Italy • Korea • Mexico • PR China • Peru • Saudi Arabia • South Africa • Spain • Uruguay • USA
- 27. What is World Presence®?
- 28. World Presence® A World Federation Strategy
- 29. World Presence® A World Federation Strategy • Regionalization
- 30. World Presence® A World Federation Strategy • Regionalization • Best practices
- 31. World Presence® A World Federation Strategy • Regionalization • Best practices • Evidence-based guidelines
- 32. World Presence® A World Federation Strategy • Regionalization • Best practices • Evidence-based guidelines • Tiered stratification of care
- 33. World Presence® A World Federation Strategy • Regionalization • Best practices • Evidence-based guidelines • Tiered stratification of care • Resource utilization
- 34. World Presence® A World Federation Strategy • Regionalization • Best practices • Evidence-based guidelines • Tiered stratification of care • Resource utilization • Quality assessments
- 35. World Presence® A World Federation Strategy • Regionalization • Best practices • Evidence-based guidelines • Tiered stratification of care • Resource utilization • Quality assessments • Education requirements
- 36. World Presence® A World Federation Strategy • Regionalization • Best practices • Evidence-based guidelines • Tiered stratification of care • Resource utilization • Quality assessments • Education requirements • Research collaboration
- 37. World Presence® Website Scientific Education Forum Regionalization Publications VITAL CARE® ARGUS®
- 38. World Presence® Scientific Forum
- 39. World Presence® Scientific Forum World Congress of Critical Care
- 40. World Presence® Scientific Forum World Congress of Critical Care Every 4 Years
- 41. 1974 London - World Congress
- 42. London - World Congress Dr. Alan Gilston
- 43. 1977 Paris -World Congress
- 44. Paris -World Congress Steering Committee Constitution 1977
- 45. Washington, DC - World Congress 1981
- 46. 1st General Assembly WFSICCM Washington, DC - World Congress 1981
- 47. 1st General Assembly WFSICCM Jerusalem -World Congress 1985
- 48. Kyoto -World Congress 1989
- 49. Madrid -World Congress 1993
- 50. Ottawa -World Congress 1997
- 51. Sydney - World Congress 2001
- 52. Buenos Aires -World Congress 2005
- 53. Florence -World Congress 2009
- 54. Durban - World Congress 2013
- 55. ??? -World Congress 2015 & 2017 ???
- 56. World Presence® Scientific Forum
- 57. World Presence® Website Scientific Forum
- 58. Website
- 59. Website • www.critical-care-world.org • Interactive map • Academy of Critical Care • e-learning • Guidelines • Courses available • Upcoming meetings, Webinars
- 60. World Presence® Website Scientific Forum
- 61. World Presence® Website Publications Scientific Forum
- 65. Journal of Critical Care • Indexed Publication • Published by Elsevier • Dr Philip Lumb – Editor-In-Chief – Past President of the Council • Impact Factor: ~ 2.3 • Support of Regionalization
- 66. Critical Care Clinics • International Perspectives in Critical Care 2006 and 2012 • State of the Art Textbook (Elsevier 2009)
- 67. World Presence® Website Publications Scientific Forum
- 68. World Presence® Website Scientific Forum Publications Regionalization
- 69. Regionalization
- 71. Regionalization • Proximity/ethnicity/heritage • Similar challenges – Priorities – Resources
- 72. Regionalization • Proximity/ethnicity/heritage • Similar challenges – Priorities – Resources • WF supported Regional leadership – Guidelines – Best practices – Integrated care – Vertical and horizontal development – Resource utilization
- 73. Regionalization • Proximity/ethnicity/heritage • Similar challenges – Priorities – Resources • WF supported Regional leadership – Guidelines – Best practices – Integrated care – Vertical and horizontal development – Resource utilization • Setting standards of care for ICU’s with limited resources
- 74. Regionalization • Proximity/ethnicity/heritage • Similar challenges – Priorities – Resources • WF supported Regional leadership – Guidelines – Best practices – Integrated care – Vertical and horizontal development – Resource utilization • Setting standards of care for ICU’s with limited resources • Preferred publication status
- 75. Regionalization • Proximity/ethnicity/heritage • Similar challenges – Priorities – Resources • WF supported Regional leadership – Guidelines – Best practices – Integrated care – Vertical and horizontal development – Resource utilization • Setting standards of care for ICU’s with limited resources • Preferred publication status • Regional Symposium twice/year
- 76. Regionalization
- 77. Regionalization
- 78. Regionalization
- 79. Regionalization
- 80. Regionalization • 2006 – Venezuela • 2007 – China and Uruguay • 2008 – Brazil and India • 2009 – Dubai and Italy – X World Congress • 2010 – Dubai and Mexico • 2011 – Dubai, South Africa and Colombia
- 81. World Presence® Website Scientific Forum Publications Regionalization
- 82. World Presence® Website Scientific Education Forum Publications Regionalization
- 90. Education Partners Guidelines BASIC
- 95. Research & Database www.infactglobal.org
- 96. Research & Database www.infactglobal.org
- 99. World Presence® Website Scientific Education Forum Publications Regionalization
- 100. World Presence® Website Scientific Education Forum Regionalization Publications VITAL CARE®
- 101. VITAL CARE®
- 102. VITAL CARE® Virtual Interactive Technology Advancing Leadership, Clinical Access, Research and Education
- 103. VITAL CARE® Virtual Interactive Technology Advancing Leadership, Clinical Access, Research and Education
- 104. VITAL CARE® Virtual Interactive Technology Advancing Leadership, Clinical Access, Research and Education
- 105. VITAL CARE® Virtual Interactive Technology Advancing Leadership, Clinical Access, Research and Education
- 106. VITAL CARE® Virtual Interactive Technology Advancing Leadership, Clinical Access, Research and Education “Leadership”
- 107. ECLIPSYS
- 108. Emphasis • Leadership development • Quality • Education • Research • Clinical support
- 109. VITAL CARE® Levels • Educational Interactive Lecture Program – Webex® – Primary and secondary centers • Quality and Research Program – TelePresence® – one on one groups – Best practices and bundle implementation – Measurement tools – Research coordination • Clinical Support – Remote Presence® – RP7i® – Specific case consultations
- 110. Webex®
- 111. Webex®
- 112. Webex®
- 113. Webex®
- 114. Webex® iPhone®
- 115. Webex® iPhone®
- 116. Webex® iPhone®
- 117. Webex® iPhone®
- 118. Education Partners
- 119. PPE
- 121. TelePresence®
- 124. TelePresence® Good!
- 126. Robotics
- 127. Robotics
- 128. Robotics
- 129. Remote Presence®
- 130. Remote Presence®
- 132. Remote Presence®
- 133. Remote Presence®
- 134. RTP Robotic Tele Presence at Orlando Regional Medical Center
- 135. The RP-7 in rounds with the Critical Care team
- 136. ICU Leadership Orlando Regional Medical Center
- 137. GPS Consultant Panel
- 138. Does it work? Does it make a difference?
- 139. Key decision are usually visual 80 70 60 50 40 30 20 10 0 Category of key information Verbal Information Visual Information % Vespa et al., Surgical Neurology,.April 2007
- 140. Verbal vs. Visual
- 141. Verbal vs. Visual Is the difference of listening to a soccer game on the radio, or...
- 142. Verbal vs. Visual Is the difference of listening to a soccer game on the radio, or...
- 143. Verbal vs. Visual watching it in high definition…
- 144. Verbal vs. Visual watching it in high definition…
- 145. RP decreases response times in critical situations 350 300 250 200 150 100 50 0 Minutes Comparison of response time Actual Response Time Customary Response Time *Face to face attending response time Vespa et al., Surgical Neurology,.April 2007
- 147. Tested around the world
- 148. Pilot Program – Mexico Dr. Gilberto Vazquez de Anda
- 149. How does VITAL CARE® work?
- 150. Consultant Network Strategic Regional Hospital
- 151. Consultant Network Strategic Regional Hospital World Presence®
- 152. Consultant Technical Partner Network Support Strategic Regional Hospital World Presence®
- 153. Affiliated Hospital Consultant Technical Partner Network Support Strategic Regional Hospital Affiliated Hospital Affiliated Hospital Affiliated Hospital Affiliated Hospital World Presence®
- 154. Affiliated Hospital Consultant Technical Partner Network Support Strategic Regional Hospital Affiliated Hospital Affiliated Hospital Affiliated Hospital Affiliated Hospital World Presence®
- 155. Affiliated Hospital Consultant Technical Partner Network Support Strategic Regional Hospital World Presence®
- 156. Affiliated Hospital Consultant Technical Partner Network Support Strategic Regional Hospital World Presence®
- 157. Affiliated Hospital Consultant Technical Partner Network Support Strategic Regional Hospital World Presence®
- 158. World Presence® Website Scientific Education Forum Regionalization Publications VITAL CARE®
- 159. World Presence® Website Scientific Education Forum Regionalization Publications VITAL CARE® ARGUS®
- 160. ARGUS Achievable Recognized Global Unit Standards
- 161. ICU Standards Leadership Workforce Physical infrastructure Resources Drugs Equipments Organizational system Training Education Supporting services Quality Patient Safety Data Performance & outcomes Research Outreach ICU subspecialty
- 162. ARGUS Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Level 7
- 163. ARGUS Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Level 7
- 164. ARGUS Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Level 7
- 167. „Nothing happens until something moves“ Albert Einstein
- 169. Thank you! 8th National Congress Turkish Society of Medical and Surgical Intensive Care Medicine Ankara, November 2011