"The implementation of self-initiated and targeted interventions to help transition the functioning of the ICU from a silo of specialists to a well-coordinated team is particularly impressive for its breadth and comprehensiveness." – Wayne Cascio
The Alfred Hospital's Intensive Care Unit (ICU) directly employs 20 Intensivists, 39 doctors in training, 400 nurses and some 20 support staff. It is a university attached quaternary referral centre, providing the National paediatric lung transplant program and State Services for heart & lung temporary replacement and retrievals, heart & lung transplantation, artificial heart technology, burns, hyperbaric medicine, adult cystic fibrosis, pulmonary hypertension, haemophilia and other severe bleeding disorders. The Alfred is one of two centres providing State Services for adult trauma, HIV and bone marrow transplantation. It has a direct budget of $50M.
In 2005, the highly regarded, experienced Intensivists functioned as individuals in a silo within the broader health service organisation. The ICU doctors and nurses saw themselves as distinct and unconnected entities and this attitude was inculcated in the doctors in training.
Consequently, the ICU failed to achieve its tremendous potential and related poorly with the rest of the hospital.
As a group, the Intensivists addressed this pattern of behavior and changed the situation through the implementation of numerous self-initiated targeted interventions.The ICU now functions as a cohesive team, delivering world's best practice and cohesive, holistic and innovative patient care.