Critical Care Medicine — Transition to Practice

TTP1 Running an ICU service

Key Features:
- This EPA focuses on managing all aspects of patient care in the ICU in the role of junior attending.
- This EPA focuses on managing the flow through the ICU: triaging referrals, managing discharges, surge and epidemic planning, delegation of responsibilities, collaborating with other health professionals and demonstrating judicious use of resources.
- This EPA may be observed in and out of the ICU, including remote sites.
- The observation of this EPA must be based on a block of time of at least a day, and preferably a week.
- The observation of this EPA is not based on running rounds or providing care for individual patients, but rather the management of the unit as a whole.

Assessment Plan:
Direct and/or indirect observation by physician
Use Form 1.
Collect 4 observations of achievement
- At least 3 different observers
- At least 4 separate encounters

Form

F1: Observation

Milestones

• ME 1.1. Demonstrate responsibility and accountability for decisions regarding patient care

• ME 1.5. Prioritize among patients based on clinical acuity

• ME 1.5. Carry out professional duties in the face of multiple, competing demands

• L 2.1. Allocate health care resources for optimal patient care

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

• ME 4.1. Coordinate the involvement of consulting services in patient care

• COL 2.2. Work effectively with other health care professionals to develop plans for clinical care when there are differences in opinion and/or recommendations

• L 4.1. Manage time and prioritize tasks

• L 4.1. Integrate supervisory and teaching responsibilities into the overall management of the clinical service

• P 4.1. Manage the mental and physical challenges that impact physician wellness and/or performance in demanding or stressful clinical settings

Context Variables

No context variables defined.

Requirements

• Collect 4 observations of achievement (minimum 4)
• At least 3 different observers (minimum 3)
  • Counted once per distinct Assessor
• At least 4 separate encounters (minimum 4)