The Intermediate Care Program (ICP) is a 12-bed unit that is used as a step up and step down unit in the Department of Medicine. The ICP accepts patients who are too sick or require more intensive nursing care than can be provided on the floors. Commonly encountered disorders include diabetic ketoacidosis, asthmatics requiring continuous albuterol therapy, complex medical patients requiring more intensive respiratory monitoring or non-invasive ventilation, and significant electrolyte abnormalities requiring close monitoring and frequent blood analyses.
The ICP physician team is composed of an attending, one senior resident, two interns and a nurse practitioner. The interns assume primary responsibility for patient care, while the senior resident serves as the team leader and supervisor. The nursing staff (who care for 1-2 patients each) and the dedicated respiratory therapist are active participants in rounds, and an interdisciplinary approach is emphasized. Rounds are carried out at the bedside, and physical exam findings are discussed daily. Given the intimate structure of the team and the higher acuity on the unit, there are many formal and informal teaching opportunities that arise. There is also a dedicated lecture series that focuses on disorders such as management of DKA, airway obstruction and respiratory compromise. Residents in the ICP take call every 4th night, and the call is viewed as an opportunity for independence and decision making for an acutely ill population. The ICP senior also acts as a "triage resident" for other teams in the hospital, performing medical consults for surgical patients, helping floor residents decide whether a patient needs transfer to a more acute unit, and lending a helping hand to other BCRP residents throughout the hospital.
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