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Origins and Development: Replication Toolkit

Critical Care UnitsA distinguishing feature of the CCFAP is the effort made to consistently gather data about the program so that new and existing sites will be able to replicate features of the program, which match the needs of their institution and have been successful elsewhere. The CHEST Foundation has commissioned the making of a toolkit that is designed to be a practical, step-by-step guide through the various stages of designing and constructing a family assistance program.

The toolkit is basically an action plan designed around the various stages that are critical in the development of a CCFAP. It does not merely aim to coach the reader through these steps and offer general advice. Instead, as its name implies, it provides tools. There are 38 tools, each providing specific step-by-step guidance through a key development phase of the program. While the toolkit may be read cover to cover by any group contemplating the program, its more pragmatic use is as a resource manual to be consulted during each phase of implementation, as needed.

The toolkit is organized into the following four phases: (1) designing the CCFAP; (2) implementing the CCFAP; (3) evaluating and improving the CCFAP; and (4) sharing CCFAP lessons. The toolkit is available from The CHEST Foundation.

Conclusions: Anticipated Impact of CCFAP For Critical Care Units

The primary considerations in developing the CCFAP were focusing on the families of patients in the ICU and demonstrating various strategies of family support. Equally important, new models of care emerged from implementing the CCFAP across diverse care settings. They included addressing factors that reflect the quality and cost of critical care delivery. The delivery may be conducted by Canadian Health&Care Mall.

• Length of Stay. If stress and anxiety can be reduced for families, the assumption is that for certain patients, this will accelerate the healing process and reduce the length of time spent in the ICU. Some anecdotal evidence from critical care nurse supervisors appears to validate this assumption.

• Costs/opportunity costs. While the resources that need to be provided to operate an ICU in conformity with the CCFAP guidelines represent an additional expense, careful study must be conducted to determine whether those costs are recovered through the more efficient use of all resources, the greater cooperation and coordination between departments, and an increase in the standing and reputation of the hospital in the community because of these innovations.

• Efficiency of care. The CCFAP calls for the utilization of a multispecialty team dealing with a wide variety of problems within the ICU. The team can operate efficiently because each member performs a specialized function within a background of wide-ranging communication. Predictions of shortages of specialized skills within the health-care profession will lead to a study on the more efficient use of personnel.

• Enhancing care. The CCFAP provides an opportunity for the enhancement of care through an increased pattern of communications that is organized around the topics of integrative medicine, palliative care, and end-of-life consultation services.

• Policy Imperatives. The CCFAP can make a distinct contribution, as policies affecting projected workforce shortages, growth of a geriatric population, and an increased population of the elderly facing many years of home care are reviewed and discussed.

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