Medical Intensive Care Unit (MICU)

Our Approach

Each year, the Medical Intensive Care Unit (MICU) at Massachusetts General Hospital treats approximately 1,200 severely ill patients using a collaborative, multidisciplinary approach to care. A multidisciplinary team provides the depth and breadth of knowledge and expertise required to care for the wide array of illnesses and complex medical conditions seen in the MICU.

The unit is staffed by attending physicians who are triple board certified in internal medicine, pulmonary medicine and critical care. They provide 24/7 coverage with assistance from fellows and residents. Approximately 110 nurses, including a clinical nurse specialist, work in the MICU. MICU nurses have received advanced training in critical care nursing, and many have received additional degrees and certifications including as nurse anesthetists and nurse practitioners.

Joining the medical intensivists and nurses on the multidisciplinary team are:

• Respiratory therapists
• Clinical pharmacists
• Clinical nutritionists
• Physical, occupational and speech therapists
• Social workers
• Case managers
• Chaplains

The 18-bed MICU, with its broad expertise caring for a variety of medical conditions, also admits patients from other ICUs when units such as cardiology or neurology are full. Standards of care established by the hospital, society and national guidelines help ensure that patients receive optimum, coordinated care regardless of which ICU they are assigned to.

What to Expect

The MICU is a patient-centered ICU and as such, families are always welcome at their loved one's bedside. After a 2005 in-house study, the MICU eliminated visiting hours so the ICU is open to families 24/7. The MICU also began a practice called “family presencing.” This enables family members to stay in the patient’s room at all times, even during a serious emergency such as a cardiac arrest. In emergencies a MICU nurse stays with the family to provide information and reassurance.

During the COVID-19 pandemic, the visitor policy had to be modified to ensure maximal patient, visitor and provider safety and continuous presence as described above has not been possible. However, throughout this challenging time, regular communication with families and loved ones remains a primary focus.

Patients, to the extent they are able, and their families participate in all discussions and decisions about their care. Because of the variety of conditions and illnesses in the MICU, length of stay varies from hours to months.

About This Program

Cutting-edge Medical Care

The Mass General Medical ICU cares for some of the most critically ill patients at Mass General and in the region. We are a referral center for other regional hospitals for specialty intensive care, which include extra-corporeal membrane oxygenation (ECMO), organ transplant services and other lifesaving interventions. The MICU staff are especially expert in the care of severe acute respiratory distress syndrome (ARDS). As such, the Mass General ICU has been at the forefront of the 2020/2021 COVID-19 response and the H1N1 crisis in 2009/2010.

Attention to Quality and Safety

Mass General maintains strict standards for quality and safety. The MICU regularly scores at or near 100% compliance with established procedures that are measured daily. Critical care standards have significantly reduced the number of bloodstream infections caused by central venous catheters and reduced the incidence of ventilator-associated pneumonia.

Contributing to the Understanding of Critical Illness

MICU physicians, who are also faculty members at Harvard Medical School, regularly conduct research and enroll their patients in clinical trials. MICU physicians and nurses have participated in research that has improved the care and experience of critically ill patients in the intensive care unit. MICU physicians have been involved in discoveries of genes involved in respiratory illness and septic shock, clinical trials that have determined which therapies are helpful in ARDS, and have participated in the development of national critical care guidelines,

Training Critical Care Specialists and Nurses

Assignments in the MICU are an important part of a fellow or resident’s medical training. The MICU is a primary training site for the Harvard Combined Pulmonary and Critical Care Fellowship, where fellows receive excellent exposure to a variety of complex illnesses and comorbid conditions. Nurses receive extensive critical care education through a 12-week MICU orientation program, as well as other training opportunities. For continuing education of the existing staff, MICU physicians and nurses attend conferences, conduct research and collaborate with colleagues at other major teaching hospitals, and organizations like the Centers for Disease Control.