Critical Care Medicine — Core of Discipline

C2 Managing patients with multisystem organ dysfunction

Key Features:
- This EPA includes the management of patients with multisystem organ dysfunction that may arise from any pathophysiology.
- This EPA includes the monitoring of organ dysfunction, managing medications based on the pharmacology and degree of organ dysfunction, and supporting the patient to allow for organ recovery where possible.

Assessment Plan:
Direct observation or case review by supervisor
Use Form 1.
Collect 10 observations of achievement
- At least 5 different observers

Form

F1: Observation

Milestones

• ME 1.6. Recognize and respond to the complexity, uncertainty, and ambiguity inherent in medical practice

• ME 1.4. Perform focused clinical assessments that address all relevant issues

• ME 2.1. Consider clinical urgency, feasibility, availability of resources, and comorbidities in determining priorities to be addressed

• ME 2.4. Develop, in collaboration with the patient and family, a plan to deal with clinical uncertainty

• ME 2.4. Establish a patient-centred management plan that considers all of the patient’s health problems

• ME 2.2. Prescribe and adjust medications in the setting of organ dysfunction

• ME 3.3. Prioritize a procedure or therapy, considering clinical urgency and potential for deterioration

• ME 4.1. Implement a patient-centred plan that supports ongoing monitoring of clinical status and response to treatment

• ME 4.1. Ensure detailed and complete follow-up and handover of all patients under the resident’s care

• ME 4.1. Determine the need and timing of referral to other specialists

• COM 5.1. Document management plans in an accurate, complete, timely and accessible manner

• COL 1.2. Consult effectively and in a timely manner with other members of the health care team and other services

• ME 2.1. Identify patients for whom the patient perceived burden of disease modifying therapy or investigations is greater than the clinical benefit

• ME 2.3. Recognize and respond to signs that it is time to transition care away from a disease modifying approach

• L 2.1. Use clinical judgement to make optimal use of limited resources

• P 1.3. Manage ethical issues encountered in the clinical setting

• S 3.4. Integrate best evidence and clinical expertise into decision-making

Context Variables

No context variables defined.

Requirements

• Collect 10 observations of achievement (minimum 10)
• At least 5 different observers (minimum 5)
  • Counted once per distinct Assessor