Abstract
Critical care is entering a phase of rapid introduction of treatments that have demonstrated efficacy for reducing mortality and morbidity. Until recently the principal question facing intensivists was “Does this treatment work?” Though that question is still important, we now must address the same challenges other fields, notably cardiology, face in implementing these practices at the bedside. This report reviews the literature on the chasm between evidence and practice, on the barriers to implementing effective practices in the intensive care unit, and novel strategies to overcome those barriers. Hundreds of thousands of patients die each year in intensive care units in the United States, and it is essential that we take a programmatic approach to addressing their health care needs.
Footnotes
- Correspondence: Gordon D Rubenfeld MD MSc, Pulmonary and Critical Care Medicine, Box 359762, Harborview Medical Center, 325 9th Avenue, Seattle WA 98104-2499. E-mail: nodrog{at}u.washington.edu.
- Copyright © 2004 by Daedalus Enterprises Inc.