Hola a tod@s, mis queridos amigos.

We share today with you the Humanization Plan of the ICU in the Community of Madrid, a reproducible and exportable model for any ICU in the world.

The plan is the result of the work during nine months of a group of 42 people (patients, families, ICU professionals and others areas -computer experts, architects, designers-) and that has been directed and advised by the members of the team of research of the IC-HU Project.

(by the moment only available in Spanish)

This is the introduccion:

“In the last thirty years, scientific and technological development of intensive care Units (ICU) has been spectacular. That is the cause of a considerable increase in the rates of survival of patients admitted into these units.

In Spain, survival has been estimated at more than 90% by the Spanish Society of Intensive, Critical Medicine and Coronary Units (SEMICYUC). The level of training of Spanish health professionals dedicated to the critical patient is high, and its performance, of excellence.

However, technology-intensive use has able to relegate the human and emotional needs of patients, families and professionals to the background. As results, the loss of narrative in the preparation of clinical stories, lack of actively listening to demands of patients and their families and the questioning of the vocation by stress. This stress stems from the lack of stable working conditions for human cuts and materials, in part due to the economic crisis, as well as the lack of social recognition.

Therefore, it is time to reflect on whether it and we should rethink a re-humanisation of assistance and improve the relationship between patients, families and healthcare professionals.

It could be understood as controversial the term “humanize”. Many people may be surprised that something so intrinsic to the healthcare profession can be subject of debate. We don´t intend to put in doubt the humanity displayed by professionals. The real objective is to get greater closeness, understanding, affection and tenderness, increasing our capacity for self-criticism and to persevere in our permanent effort to improve. To retrieve the service to people commitment, that originally fueled our vocation as professionals, is a challenge and a necessity of great magnitude and general interest.

The action of humanizing is made from inside to out. It is an important personal commitment to improve our reality, relationships and personal environment. Stopping to think and see what everyone can bring to the system is getting the change as a process where the attitude is crucial. Our health care system may be considered humanized when it will be at the service of all those who comprise it: patients, families and professionals health at all levels.

The integral attention requires subjectivity, skills, sensitivity and ethics. It needs great communication and relationship skills: active listening, respect, empathy and compassion. A set of fundamental tools in which professionals, to a greater or lesser extent, have curriculum gaps. These educational resources are essential to promote and improve humanisation training. Aware of this, since the own ICU of the Community of Madrid more flexible visiting policies, measures to improve the well-being of patients and family members, satisfaction surveys and protocols of adaptation of end of life care have been implemented.

In addition, the Ministry of Health has prioritized the humanization of Health assistance in the Community of Madrid as one of the strategic lines of the present legislature.

in September 2015, in order to develop a project which goal is the “humanization of Intensive Care Units” and with the aim of providing a methodology so that the ICU in the community of Madrid will provide an attention of excellence, humanized and focused on persons, creating a more friendly ICU for patients, families and professionals, was created a technical Committee consisting of health professionals (intensivists, Pediatric intensivists, nurses, physiotherapists) engaged in activities of humanisation, including representatives of the Society of Intensive Medicine of the Autonomy of Madrid (SOMIAMA), patients and external experts. This Committee was supported on external experts, members of the IC-HU international research project, and the support of the General Directions on Care Coordination and humanization of the Health care and Planning, Research and Training, belonging to the Ministry of Health.

The Committee established eight strategic lines of work. Each line was addressed by a work Committee, consisting of members of the Committee with the help of external experts that each Commission considered necessary.

The documents prepared by the committees were discussed and agreed at meetings of the technical group to prepare a first version of the document. This version was subsequently discussed with representatives from all ICU of Madrid, to develop a proposal for prioritization and implementation of measures, alltogether with the Ministry of health.

The following programs and fields of intervencion were priorized:

1. Open ICU visiting policies
2. Communication
3. Well-being of patient
4. Presence and participation of relatives in intensive care
5. The care of the professional
6. Prevention, management and follow-up of the Post Intensive Care Syndrome
7. Humanized infrastructure
8. End of life care

I am very proud and grateful for being responsible for this document, which we are sure will serve to change gradually and each ICU at their pace towards a more friendly and people-centered intensive care units arround the world.

Now it is time implementing it, for whith it would be necessary to assess what the current situation of every ICU about the eight points and establish a own work plan.

And we will do it together. By the way, we need urgently translators into English (contact with gabihache@hotmail.com).

Happy Tuesday,