Surgical critical care services

Purpose

To provide standardized approaches to the care of surgical critical care patients.

Policy

Clinical Practice Guidelines (CPG) are meant to standardize and optimize care and decrease variability in practice. They are intended to be used as framework for the delivery of patient care in the surgical critical care units. CPG’s are a combination of evidence-based medicine and accepted practices in critical care medicine. CPG’s are intended to provide decision support for the management of the majority of patients, and are not proposed as directives, rules, or policies. They are not substitutes for clinical judgement. Deviations from the CPG’s are expected when deemed medically necessary; all exceptions should be documented in the medical record and require discussion between the Surgical Critical Care attending and the attending of the primary or consulting service.

Procedure

1. Topics for the development of CPG’s are determined by both the Surgical Critical Care staff and the surgical services. CPG’s are directed at high-volume clinical situations, complex multi-disciplinary management issues, or problems identified through the Performance Improvement program.
2. CPG development will be based on accepted professional practice and review of the pertinent medical literature. Multidisciplinary representation will be solicited in the developmental phase, as indicated. This may include input from a variety of surgical and nonsurgical specialties, nursing staff, and allied health professionals as appropriate to the CPG.
3. The format for CPG’s will include an introduction, pertinent review of the literature, purpose, and interventions.
4. CPG’s will be reviewed in appropriate inter-disciplinary forums, and approved for the Department of Surgery-Anesthesia-Neurosurgery during the monthly critical care faculty meeting. The medical directors of the Surgical Critical Care Services will be responsible for development and approval of CPG’s.
5. Implementation of CPG’s will require inservicing of nursing staff on Surgical Critical Care units, faculty, Advanced Practice Nurses, fellows, residents, and allied health professionals. Approved CPG’s will be available to the Surgical Critical Care units either through hardcopy or intranet.
6. Change of therapy or practice from CPG’s will be documented by the attending Surgical Critical Care physician or designee in agreement with the primary or consulting service.
7. Compliance with CPG’s will be monitored by the Surgical Critical Care Nurse Practitioner as part of the Performance Improvement program. Complications will be reviewed relative to the established CPG, and filtered through the performance improvement process, as indicated.
8. CPG’s will be reviewed every 3 years, at minimum, by the surgical critical care faculty.

Clinical Practice Guidelines (CPG)

• PennPathways on AgileMD

Anesthesiologists

Andrew Gold
Assistant Professor of Clinical Anesthesiology and Critical Care

Emily Gordon
Associate Professor of Clinical Anesthesiology and Critical Care

C William Hanson
Professor of Anesthesiology and Critical Care

Jiri Horak
Associate Professor of Clinical Anesthesiology and Critical Care

Meghan Lane Fall
Associate Professor of Epidemiology in Biostatistics and Epidemiology

Arpit Patel, MD
Physician

Kristen Rock
Assistant Professor of Clinical Anesthesiology and Critical Care

Hazel Werlhof
Assistant Professor of Clinical Anesthesiology and Critical Care

Advanced Practice Providers

Corinna Sicoutris, CRNP
Director of Advanced Practice, HUP

Tara Collins, CRNP
Director of Advanced Practice, PPMC

Melissa Dunlop, PA-C
Director of Advanced Practice, PAH

Jason Saucier, CRNP
SCCS Manager

Amy Matta, CRNP
Lead APP of HUP SICU

Elizabeth Merulla, CRNP
Lead APP of PPMC TSICU

Dominic Gatta, CRNP
Lead APP of PAH SICU 

Marissa Berlant, PA-C

Jennie Berman, CRNP

Jessica Bird, CRNP

Sarah Braun, PA-C

Nicole Bryan, PA-C

Krissy Buckley, CRNP

Eric Campbell, PA-C

Katie Campbell, PA-C

Cortney Cragg, CRNP

Tricia Czar, CRNP

Caroline Daroci, CRNP

Alexandra Drewicz, CRNP

Greta Eggenberger, PA-C

Erin Henry, CRNP

Mary Herc, PA-C

Kathleen Hirsch, CRNP

Nichole Hughes, PA-C

Elizabeth Long, CRNP

Sarah Lynch, CRNP

Mandy Martin, CRNP

Rebecca Mikolai, CRNP

Amanda Miller, PA-C

Joe Milorey, CRNP

Sarah Naber, PA-C

Christopher Parncutt, CRNP

Elizabeth Peitzman, PA-C

Kristan Reutlinger, CRNP

Lauren Robinson, CRNP

Allison Ryan, CRNP

Elizabeth Sheridan, CRNP

Haley Smith, CRNP

Caroline Stires, CRNP

Alyssa Thomas, PA-C

Blessen Thomas, PA-C 

Victoria Vardilli, CRNP

Anesthesia Critical Care Fellows

Hesham Ezz, MD
Residency Program: Yale New Haven Hospital Cleveland Clinic

Andrew Graziano, MD
Residency Program: University of Missouri – Kansas City

Shannon Hayley, MD, PhD
Residency Program: Thomas Jefferson University Hospital

Nurse Leadership

Christine Aiello

Sebastian Ramagnano

Julianna Santine