Care Redesign

My Favorite Slide: The ICU and the Human Care Bundle

Infographic · April 5, 2018

Care Design - The H-Evolution of Intensive Care Units - ICU and Human Care Bundle Human-Centered Care Model

  Click To Enlarge.

Since February 2014, the International Research Project for the Humanization of the Intensive Care Units (Proyecto HU-CI) has been focusing on the need to redesign ICUs around the world. We have been asking patients, families, and professionals (everyday stakeholders) to describe their ideal ICU.

The eight aspects of care shown in the slide are linked to improving the management of the ICU with a human beingcentered care model. Each area has a unique function, but only when they work together can the ICU really be humanized. Each element impacts the others, and coordination is essential to achieve a gold standard of ICU care.

For example, an open-door visitation policy in an ICU encourages families to be involved in the patient’s care, and significantly improve both patient and family well-being. These eight components represent a human care bundle, which aims to improve the health care processes and clinical outcomes.

Among the metrics we are monitoring are ICU length of stay, reduction of readmissions, security of patients, reduction of cost, and satisfaction of patients, families, and professionals.

Our Success Keys

  • Building a human-centered culture involves the development of individual and collective attitudes, competencies, and behavior patterns of the health care stakeholders, and can influence the commitment, style, and mastery of management for an organization.
  • Achieving humanization of the culture will allow us to focus on the needs of the patients, families, and professionals, meeting the real reason of being for the organization. The fundamental elements needed: leadership, teamwork, scientific evidence, communication, and people-centered care.
  • Training for care professionals (and for patients and families, too) in specific humanizing skills enhances patient and provider engagement within the organization, and helps reconnect professionals with their real vocation, and can boost passion and energy even when facing challenging clinical cases.
  • Research allows us to generate scientific evidence to support the hypothesis that these work strategies and specific actions can improve humanization. They are not only feasible, but necessary, to bring value to health care attention by improving results.
  • Innovating can improve attitudes around existing care elements, as well as in hospital design.
  • Continuous evaluation of the humanization of resources and processes and the results of those efforts allows us to track the improvement of the quality of the provided services.

This Project was born in Spain and has spread to more than 20 countries. In Spain, the concept has been adopted beyond the ICU, to include urgent and emergency care, oncology, pediatrics, and neurology. Why not extend this to the whole health care system?

Call for submissions:

Now inviting expert articles, longform articles, and case studies for peer review

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

More From Care Redesign
The Assessment of Care Tool - Consisting of Six Visual Analog Scales Corresponding with the IOM Six Dimensions of Perfect Care

Real-Time Pursuit of Outcomes That Matter to Patients

A simple and affordable tool to use at the point of care to drive value creation within clinical microsystems.

Many Patients Who Would Benefit from Palliative - End-of-Life Care Do Not Receive It

Care Redesign Survey: The Power of Palliative Care

Our NEJM Catalyst Insights Council survey on palliative care reveals an interesting dichotomy: While the great majority of organizations have a palliative or end-of-life care program, 60% of patients who would benefit from such services don’t receive them.

Heart Safe Motherhood and Way to Health Two-Way Texting for Blood Pressure Monitoring for Postpartum Women with Preeclampsia

Heart Safe Motherhood: Applying Innovation Methodology for Improved Maternal Outcomes

At the Hospital of the University of Pennsylvania, a text message–based blood pressure surveillance program for postpartum women with preeclampsia improved blood pressure management, reduced readmissions, and increased patient and provider satisfaction.

VHA Whole Health System diagram

Finding the Cause of the Crises: Opioids, Pain, Suicide, Obesity, and Other “Epidemics”

Until we redesign our health care system to address our patients’ personal determinants of health, we will continue to inadequately address our multiple chronic disease crises.

Leff06_pullquote home-based medical care for homebound patients

Using Quality to Shine a Light on Homebound Care

How two thought leaders in the fields of home-based medical care, geriatrics, and palliative medicine advanced a quality-of-care agenda for homebound adults.

Charlotte Yeh head shot - hearing aids hearing loss

“You’re Old Without Hearing Aids”— Addressing the Silent Epidemic of Hearing Loss

Hearing loss isn’t a normal consequence of aging. But it is associated with a higher risk of dementia, depression, and falls. The Chief Medical Officer for AARP Services talks about combating this huge but silent epidemic that impacts all ages.

Dentzer01_pullquote - Stone-Age Policies Stifle Modern Virtual Care Solutions

Stone-Age Policies Stifle Modern Solutions

Health care leaders must advocate for regulatory and reimbursement changes to unlock the potential of innovative technology and care team approaches to Parkinson’s and other suitable conditions.

Idiopathic Pulmonary Fibrosis IPF Multidisciplinary Collaborative Care Model

From Consulting to Caring: Care Redesign in Idiopathic Pulmonary Fibrosis

A multidisciplinary collaborative model to address the palliative care needs of patients with idiopathic pulmonary fibrosis resulted in improved end-of-life care and decreased hospital deaths.

Impact of PCSP on Patient Satisfaction at Providence Heart Clinic

Transforming Specialty Practice in Pursuit of Value-Based Care: Results from an Integrated Cardiology Practice

Despite significant primary care reform around patient-centered medical home models, specialty care remains fragmented, with poor communication between primary care and specialists. How should specialty practices be reformed to deliver more coordinated, patient-centered care?

Michael Bennick Yale New Haven Hospital Medical Director of the Patient Experience - Yale Living History Project

The Living History Project: Open-Ended Patient Interviews Create a Therapeutic Bridge

A program at Yale has students conduct open-ended interviews with patients about their lives, their hopes, their values, and what they most want their medical team to know — creating the opportunity for human connection and a better care experience.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Coordinated Care

136 Articles

Care Redesign Survey: The Power of…

Our NEJM Catalyst Insights Council survey on palliative care reveals an interesting dichotomy: While the…

Primary Care

188 Articles

China’s Health Care: Public Benefit, Enormous…

Though demand for health services in China has outpaced the development of management systems to…

Mental Health

30 Articles

Finding the Cause of the Crises:…

Until we redesign our health care system to address our patients’ personal determinants of health,…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now