Intensivist Service

What is an Intensivist?

Intensivists are board-certified physicians in internal medicine, pulmonology, and critical care, and lead a team of specialists in the CCC's Intensive Care Unit (ICU).

At OSF St. Joseph Medical Center, ICU patients with critical or severe illness or injury receive extensive, round-the-clock care and monitoring. The care of each patient in the ICU is carefully and closely managed by a team of pharmacists, nurse practitioners, clinical nurse specialists, nurses, respiratory therapists, and intensivists.

The term intensivist is not new in health care. There are close to 8,100 intensivists in active practice in the United States, who provide one-third of all ICU care. However, with so few intensivists in the United States it's no wonder most hospitals are without these specialists on their ICU team.

Why OSF St. Joseph Medical Center Stands Out

For the past five years, David West, MD, has been the medical center's "go-to" intensivist. However, in September 2008, OSF St. Joseph Medical Center saw the growing demand for intensive care specialists in the community.

The medical center, then, named Kishore Karamchandani, MD, director of OSF Critical Care, Pulmonary, and Sleep Medicine, and hired an additional physician, Ravi Kashyap, MD.

With more than 40 years of experience among them, OSF St. Joseph Medical Center's intensivist team grew to three full-time physicians, one part-time physician, Sylvia Hatseras, MD, and an advanced practice nurse, Susan Dudek, RN, APN.

"We are team-oriented and patient-focused," Dr. Karamchandani said. "If a patient is admitted into the hospital now, it's because they are really sick. We use a holistic approach to get them well sooner and with less cost."

During rounds, the team provides a daily plan of care for the patient with a focus on the patients' needs. The intensivist on duty is responsible for implementing the plan, as well as monitoring and managing each individual patient's progress. Intensivists are also involved in all aspects of the patient's post-ICU course, including follow-up visits.

"Our nursing staff is key," Dr. West said. "The ICU team functions as one, but our nurses have more one-on-one time with each patient and therefore are critical to our success."

Since the induction of the team-approach, Jan Crawford, CCC nurse manager, has seen a great improvement in overall patient satisfaction.

"The intensivists have embraced the nursing staff as an integral part of their team," Jan said. "Doing so created a new culture around the ICU. The nurses are receiving more education, input on our patients' plan of care, and positive feedback."

The increase in patient satisfaction scores in the CCC can be attributed to the hands-on team approach the intensivists have created, Jan said.

The addition of a nurse practitioner to the ICU team has also helped facilitate open communication between the nurses and physicians. Susan is a valuable mentor and educational resource for the nurses in the CCC, Dr. West said.

"Here at OSF St. Joseph Medical Center, the team approach is valuable to the community, allowing interdisciplinary care for every ICU patient," Susan said. "The intensivists' expertise and presence allows ill individuals to be transferred here, or remain here, locally, for care, rather than be transferred to Chicago, St. Louis, or other larger cities."

Mortality rates are significantly lower in hospitals with ICUs managed exclusively by board certified intensivists - more specifically 30 percent lower hospital mortality and 40 percent lower ICU mortality.

Furthermore, the average length of stay in an ICU is 6.1 days for patients cared for by an intensivist, compared with 9.3 days for patients cared for by an attending physician, and overall complication rates in ICUs staffed with intensivists are 44 percent versus 56 percent in traditionally staffed units.

"Studies have shown that the use of intensivists is becoming the gold standard for intensive care units," Dr. Karamchandani said. "Bloomington/Normal is fortunate to have a medical center that has invested its resources to provide this level of care."

Contact Information

For more information about our intensivists, please call OSF Critical Care, Pulmonary, and Sleep Medicine at (309) 661-2368.