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Ideas and Opinions |

Maintaining Connections: Some Thoughts on the Value of Intensive Care Unit Rounding for General Medicine Ward Teams

Joel D. Howell, MD, PhD
[+] Article, Author, and Disclosure Information

From the University of Michigan, Ann Arbor, Michigan.

Acknowledgment: The author thanks Theodore (Jack) Iwashyna and Sanjay Saint for their helpful comments.

Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0892.

Requests for Single Reprints: Joel D. Howell, MD, PhD, Division of General Medicine, 300 North Ingalls Building, Room 7C27, University of Michigan, Ann Arbor, MI 48109-5429; e-mail, jhowell@umich.edu.

Author Contributions: Conception and design: J.D. Howell.

Analysis and interpretation of the data: J.D. Howell.

Drafting of the article: J.D. Howell.

Critical revision of the article for important intellectual content: J.D. Howell.

Final approval of the article: J.D. Howell.

Collection and assembly of data: J.D. Howell.

Ann Intern Med. 2011;155(5):323-324. doi:10.7326/0003-4819-155-5-201109060-00010
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When established ward patients are unexpectedly transferred to an intensive care unit (ICU), the ward team should continue to follow them. Although there may be reasons not to do so, the advantages outweigh the obstacles. Great pedagogic value can be gained from following patients after acute decompensation, but a more important reason is that by following patients into the ICU, the ward team can enact for both patients and their families the twin virtues of caring and continuity. Doing so also demonstrates the highest ideals of medicine—that we are focused not on defined areas of turf, but on our patient's well-being. It shows that we are not merely doing narrowly defined “shift work,” but that we truly care about our patients. Rounding on established patients who have been transferred into the ICU is the sort of behavior that undergirds the fundamental bases of professionalism. It takes a few minutes from a busy day, but it can be incredibly beneficial for families, patients, and the ideals of medicine.





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