Critical Care Medicine — Core of Discipline

C8 Caring for patients with prolonged ICU stay and/or organ support-dependent critical illness and their primary caregiver(s)

Key Features:
- This EPA includes the coordination and care for long-term and/or organ support-dependent critically ill patients in the ICU or other settings.
- This EPA requires longitudinal engagement with the patient, family, and multidisciplinary team.
- It includes tasks such as orchestrating family meetings, developing and leading the implementation of care plans including possible homecare, or transfer to community hospital or long-term care facilities.
- It requires the coordination of multidisciplinary teams and advocacy at the patient and system level.

Assessment Plan:
Direct observation and/or case discussion by supervisor with or without input from physiotherapist, social worker, registered respiratory therapist, patient or family.
Use Form 1.
Collect 2 observation of achievement
- At least 2 different observers

Form

F1: Observation

Milestones

• ME 1.6. Adapt care as the complexity, uncertainty, and ambiguity of the patient’s clinical situation evolves

• 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

• COM 2.1. Gather information about the patient’s beliefs, values, preferences, context and expectations with regards to their care

• ME 2.3. Address the impact of the medical condition on the patients’ ability to pursue life goals and purposes

• ME 2.3. Work with the patient and family to establish goals of care

• COM 3.1. Provide information on diagnosis and prognosis in a clear, compassionate, and respectful manner

• COM 4.3. Use communication skills and strategies that help the patient and family make informed decisions

• ME 2.2. Select investigations and therapies appropriate to the patient’s goals of care

• ME 2.4. Develop and implement management plans that support achievement of the patient’s goals of care

• ME 4.1. Coordinate ongoing care when multiple physicians and health care professionals are involved

• HA 1.1. Facilitate timely patient access to services and resources

Context Variables

No context variables defined.

Requirements

• Collect 2 observation of achievement (minimum 2)
• At least 2 different observers (minimum 2)
  • Counted once per distinct Assessor