Patient and Provider Dependent Metrics in Team-Based Care Models in Military Intensive Care Units

Health care systems are facing an increased demand for intensive care coupled with a shortage of intensivist-trained physicians in the United States. Recognizing that patients improve with around-the clock intensivist coverage, health care organizations are adopting health care models that expand these traditional physician intensivist models. Institutions are incorporating Acute Care Nurse Practitioners ACNPs into team-based care models to intercede for patient care in intensive care units ICUs. While military hospitals have begun to adopt these team based care models, no studies have addressed indicators to measure the role and outcomes of ACNPs in military ICUs. The purpose of this study is to identify and compare patient and provider dependent care outcome measures in military ICUs utilizing traditional and team-based staffing models. A retrospective review of medical records was conducted of all patients admitted to either medical, surgical, or trauma ICUs at one U.S. military medical center for the 12 months prior to study initiation. Twenty ACNP applicable outcome measures were identified from the literature and utilized as the variables for data extraction in both the traditional and team-based ICUs. Records from 2637 patients admitted to the ICUs were extracted to identify the outcome measures, incidence of outcome measures, and then compared to outcomes between units and to similar civilian units. Outcome measures evaluated were found to be comparable between team-based and traditional units as well as to similar civilian units. Identifying outcomes measures of the ACNPs in a military ICU to deliver safe, trusted care is the mission of the military medical services and these study results can inform their use in future in military medical settings