Reviewer: David J. Dries, MD (University of Minnesota Medical School)
Description: This is a softbound commentary on issues surrounding the use of intensive care unit resources.
Purpose: The book provides a contemporary description of the function of the intensive care unit with a focus on organization and policy affecting admission and discharge of patients and allocation of resources. As managed care initiatives and shrinking resources sweep American and other healthcare systems, this commentary is an appropriate and important contribution.
Audience: The practitioner at all levels, medical and nursing, may benefit from this work. The authors include a nationally known intensivist with an interest in health services research and a professor of management.
Features: The authors provide a background on intensive care unit development and organization, and then use a case scenario format to describe issues surrounding utilization of resources. Public policy statements and previous legislation in this area are reviewed. Appendixes contain statements from various critical care societies regarding intensive care unit utilization and the ethical evaluation of intensive care unit utilization. A role-playing format is used to stimulate interaction of multiple readers in this work. The excellent references date to within one to two years of publication. The occasional figure encountered is black and white and easily read.
Assessment: This book accomplishes its goals in an admirable fashion. The practitioner and administrator of critical care will benefit from this work. The student or trainee within this discipline should understand the issues developed here. Key literature and issues relevant to medical resource utilization are reviewed in a readable and useful style.