b'The New Paradigm: Interconnected thinking In the new way of thinking, the viewpoint expandsunproductive, and unfocused for years, leaving out beyond the siloed cost of the ICU department andprecisely the most important discussions on goals of considers how the impact of a well-managed criticalpatient care.care program will ripple throughout the hospital ecosystem. It includes both cost savings and previouslyTheoperationalleaderssitevisitsshouldserveasunrecognized gains that are real but not inherentlyextensions of the questionnaire, an opportunity to obvious from an accounting perspective. This new wayobserve and go deeperto learn the good, the of thinking about critical care is not only necessary butbad, and the ugly. Practiced leaders will be able to potentially transformative. sensitively but clearly discern where hidden problems may lie and where the roadblocks are when successfully To facilitate interconnected thinking, we must align theimplementing a critical care program.thinking across the clinical and C-suite leaders who manage the ICU. There are two sets of strategies: up- By aligning the bedside thinking and the C-suite thinking close clinical and high-level strategic. I call these twoduring the assessment period, existing realities are groups bedside thinking and C-suite thinking. acknowledged, shared goals are created, and care teams can begin to design solutions mutually and Operatingacriticalcareprogramintodaysenvironment collaboratively. challengestheC-suitetothinkdifferentlyinanumberofareas,includingintegratedstaffingplans,nurse training, expanded responsibility for APPs, a comprehensive recruiting (people) strategy that wisely deploys telemedicine to address new use cases, and interconnected leadership to ensure broad alignment.The discovery period in every new ICU program typically involves a lengthy questionnaire. These questionnaires cover everything from broad questions designed to give a basic overview of the size and scope of the existing programtomorespecificquestionsaboutperformancedata, operations, credentialing, scheduling, and clinical management.As experienced critical care leaders know, these questionnairesareusuallyinsufficientforsurfacingthereal pain points and problems of an ICU. In fact, the traditional mechanisms of assessing the needs of an ICU program are inherently steeped in the old way because they are absent the dialogue and collaboration needed intodaysenvironment.Real-timediscoveryoftenhappens when leaders work alongside their clinical care teams onsite. Only then will you discover that, while the site may have answered yes to a question about whether they are doing interdisciplinary rounding, the truth is that this process has been inconsistent, Together, we healTogether, we heal 3Together, we heal SCP HEALTHIBRINGING THE C-SUITE TO THE BEDSIDE IN CRITICAL CARE MEDICINE'