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J Emerg Trauma Shock. 2018 Jan-Mar;11(1):65-70. doi: 10.4103/JETS.JETS_9_17.

The Intensive Care Unit Perspective of Becoming a Level I Trauma Center: Challenges of Strategy, Leadership, and Operations Management.

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Maimonides Medical Center, Adult Critical Care Services, Brooklyn, New York, USA.
Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA.
Division of Acute Care Surgery, Maimonides Medical Center, Brooklyn, New York, USA.


The primary purpose of this narrative is to elucidate the numerous significant changes that occur at the intensive care unit (ICU) level as a medical center pursues becoming a Level I trauma center. Specifically, we will focus on the following important areas: (1) leadership and strategy issues behind the decision to move forward with becoming a trauma center; (2) preparation needed to take a highly functioning surgical ICU and align it for the inevitable changes that happen as trauma go-live occurs; (3) intensivist staffing changes; (4) roles for and training of advanced practice practitioners; (5) graduate medical education issues; (6) optimizing interactions with closely related services; (7) nursing, staffing, and training issues; (8) bed allocation issues; and (9) reconciling the advantages of a "unified adult critical care service" with the realities of the central relationship between trauma and surgical critical care.


Accreditation Council for Graduate Medical Education; administration; intensivist; nursing staffing; operations management; patient throughput; resident training; surgical intensive care unit; table of organization; trauma center

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