CHEST Guidelines-Do-the-Right-Thing

Do-the-Right-Thing_chest

Pdf Summary

The editorial "Do the Right Thing" by Michael J. Lanspa and Ithan D. Peltan in CHEST discusses the significance of consistency and adherence to evidence-based practices in improving patient outcomes in high-acuity Intensive Care Units (ICUs). The discourse is supported by a study conducted by Vranas et al., which found that adherence to evidence-based practices, such as glucose management and blood transfusion best practices, is more prevalent in high-acuity ICUs, leading to better patient outcomes. This consistency challenges the idea that high-acuity ICUs perform better because of the inherent skills or intellect of their clinicians.<br /><br />The editorial highlights that deviations from best practices are often unintentional and rooted in the difficulty of integrating complex data streams. It further argues that while the consistent application of evidence-based therapies might seem straightforward, it is crucial yet often neglected, especially in the face of the COVID-19 pandemic where some intensivists rely on unproven experimental therapies over established best practices.<br /><br />The article posits that the value lies not in novel medications or therapies but in widely implementing known effective therapies. Consistency, achieved through institutional practices and support systems like computerized protocols, can significantly improve outcomes in ICUs.<br /><br />In essence, the editorial stresses the importance of reinforcing the consistent application of established therapies and suggests that successful ICU teams are those that cultivate an environment where adherence to best practices is prioritized and facilitated. The message serves as a reminder, specifically amid ongoing challenges like the COVID-19 pandemic, to focus on doing the right thing consistently to improve patient care and outcomes.

Keywords

evidence-based practices

high-acuity ICUs

patient outcomes

glucose management

blood transfusion

COVID-19 pandemic

consistent application

institutional practices

computerized protocols

intensive care units