Critical Care Medicine — Academic days

Quality in the ICU

Competencies covered in this activity

1. Practise medicine within their defined scope of practice and expertise
	1.1. Demonstrate a commitment to high-quality care of their patients
	1.3. Apply knowledge of the clinical and biomedical sciences relevant to Critical Care Medicine
		1.3.1. Normal and abnormal anatomy, including the appearance with diagnostic imaging
		1.3.2. Pathophysiology of:
			1.3.2.1. Organ dysfunction
			1.3.2.2. Sepsis
			1.3.2.3. Blunt and penetrating trauma
			1.3.2.4. Environmental injuries
		1.3.3. Physiology in critically ill women who are pregnant
		1.3.4. Developmental physiology and pharmacology in adolescents
		1.3.5. Psychosocial needs of adolescent patients and their families
		1.3.6. Pharmacology
			1.3.6.1. Agents used for neuromuscular blockade
			1.3.6.2. Antimicrobial therapies
			1.3.6.3. Common intoxicants and poisons, and specific antidotes or supportive therapies
			1.3.6.4. Sedatives and analgesics
			1.3.6.5. Vasoactive agents
		1.3.7. Principles and practice of resuscitation
		1.3.8. Principles and practices of assisted mechanical ventilation and other methods of respiratory support
		1.3.9. Principles and methods of invasive and/or non-invasive monitoring
			1.3.9.1. Respiratory status
			1.3.9.2. Hemodynamic status
			1.3.9.3. Neurologic status
			1.3.9.4. Nutritional status
		1.3.10. Principles of the determination of neurological death
		1.3.11. Principles of medical transport
			1.3.11.1. Physiology during transport, including air transport
			1.3.11.2. Modes of transportation, patient care equipment, and monitoring methods
			1.3.11.3. Role of paramedical personnel
		1.3.12. Principles for the coordination and triage of services for mass casualty management
	1.4. Perform appropriately timed clinical assessments with recommendations that are presented in an organized manner
2. Perform a patient-centred clinical assessment and establish a management plan
	2.4. Establish a patient-centred management plan, for the following
		2.4.1. Shock: distributive; hypovolemic; cardiogenic; obstructive
		2.4.2. Acute critical illness of any etiology
			2.4.2.1. Single or multiple organ dysfunction
			2.4.2.2. Oncologic emergencies
			2.4.2.3. Trauma and environmental injuries
			2.4.2.4. Sepsis
			2.4.2.5. Intoxication
			2.4.2.6. Perioperative care
		2.4.3. Chronic critical illness
		2.4.4. Pain and symptom control
		2.4.5. End of life, including goal-directed life-sustaining therapies
		2.4.6. Organ and tissue donation
		2.4.7. Critical illness in pregnancy
		2.4.8. Perioperative risk optimization
3. Plan and perform procedures and therapies for the purpose of assessment and/or managemen
	3.4. Perform diagnostic and therapeutic procedures in a skilful and safe manner, adapting to unanticipated findings or changing clinical circumstance
		3.4.5. Breathing
			3.4.5.1. Ventilation by bag and mask
			3.4.5.2. Initiation of and weaning from assisted ventilation
			3.4.5.3. Maintenance of long term assisted ventilation
			3.4.5.4. Thoracostomy tube insertion
			3.4.5.5. Thoracentesis
			3.4.5.6. Fiberoptic bronchoscopy in the intubated patient
4. Establish plans for ongoing care and, when appropriate, timely consultation
	4.1. Implement a patient-centred care plan that supports ongoing care, follow-up on investigations, response to treatment, and further consultation
5. Actively contribute, as an individual and as a member of a team providing care, to the continuous improvement of health care quality and patient safety
	5.1. Recognize and respond to harm from health care delivery, including patient safety incidents
	5.2. Adopt strategies that promote patient safety and address human and system factors
		5.2.1. Apply the principles and techniques of infection prevention and control, including those for the protection of health care workers

1. Establish professional therapeutic relationships with patients and their families
	1.2. Optimize the physical environment for patient comfort, dignity, privacy, engagement, and safety

1. Contribute to the improvement of health care delivery in teams, organizations, and systems
	1.1. Apply the science of quality improvement to contribute to improving systems of patient care
		1.1.1. Identify environmental hazards and promote safety for patients and staff
		1.1.2. Identify, analyze, and minizime risk of critical icidents, adverse events, complications of critical illness
		1.1.3. Implement quality improvement activities, including evidence-based practice, best practice guidelines and benchmarking, and change management
		1.1.4. Participate in the processes of clinical audit and peer review
	1.2. Contribute to a culture that promotes patient safety
	1.3. Analyze patient safety incidents to enhance systems of care
	1.4. Use health informatics to improve the quality of patient care and optimize patient safety
2. Engage in the stewardship of health care resources
	2.1. Allocate health care resources for optimal patient care
	2.2. Apply evidence and management processes to achieve cost-appropriate care

2. Respond to the needs of the communities or populations they serve by advocating with them for system-level change in a socially accountable manner
	2.2. Improve clinical practice by applying a process of continuous quality improvement to disease prevention, health promotion, and health surveillance activities

2. Demonstrate a commitment to society by recognizing and responding to societal expectations in health care
	2.2. Demonstrate a commitment to patient safety and quality improvement