Remote technologies improve patient care as a viable alternative to intensivist shortage

Orlando 08 December 2009During the Institute for Healthcare Improvement National Forum, Advanced ICU Care showcased the improved outcomes of implementing virtual ICU technology. Five million patients are admitted to ICUs each year and an estimated 10 percent die while they are there. While full intensivist staffing would save 162.000 lives annually, only one in five ICUs has intensivists on staff. Remote monitoring programmes for ICUs are a viable alternative to the intensivist shortage and improve patient care and safety.

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"With all that is at stake, we need to get it right in the ICU", stated Mary Jo Gorman, MD, MBA, chief executive officer of Advanced ICU Care. "The improvements made possible by virtual ICU technology bring a life-saving level of care. It really is becoming the new standard of care for community hospitals striving to provide the best possible quality care to ICU patients."

St. Mary's Health Center, an SSM Health Care facility in Jefferson City, Missouri, implemented a virtual ICU programme, along with its in-house programme, in January 2006. The results show significant improvements in ICU mortality, length of stay and quality measures:

  • ICU mortality dropped by 24 percent after one year
  • Cardiac arrests plunged by 69 percent
  • ICU patient total length of stay fell by 14 percent
  • Zero cases of ventilator-associated pneumonia (VAP) since programme inception
  • Drop in central line infections (just two in three years since programme implementation)
  • Median days on ventilator fell by a full day
  • Standardization of glucose management

"We recognized the need for around-the-clock intensivist care in the ICU, but had difficulty recruiting and securing full time physicians. We were concerned, as were many hospitals, about the lack of coverage during office hours; competing priorities for consulting physicians, especially at night and on weekends; physician availability in emergency situations; and high ICU nursing turnover, partly due to delays in reaching physicians", stated Dr. John Lucio, vice president of medical affairs, St. Mary's Health Center. "We identified virtual ICU technology as a solution to our challenges. We worked as one team with Advanced ICU Care and the results are clear - improved patient care and safety in our ICU."

While St. Mary's goal focused on the ICU, quality improvements extended far beyond. The hospital jumped to the top one percent in the Centers for Medicaid and Medicare Services (CMS) core measures, as measured by Health Insight.

United States hospital ICUs continue to encounter an intensivist shortage; less than 20 percent have dedicated intensivists on staff. Studies show care provided by intensivists, whether at the bedside or via telemedicine technology, greatly increases the quality of ICU care. The Advanced ICU Care programme deployed at St. Mary's provides 24/7 monitoring to ICU patients by experienced, board-certified intensivists and critical care nurses.

"This technology combines clinical management software with patient information and remote care tools, enabling the remote monitoring and care of ICU patients by intensivists and critical care nurses", stated Dr. Isabelle Kopec, vice president of medical affairs, Advanced ICU Care. "By embracing technology-based programmes, as St. Mary's did, hospitals can recognize significant process improvements, resulting in better quality and safety of care; improved financials; and strong partnerships among in-house staff and remote specialists to drive quality care."

Advanced ICU Care is a medical service company that provides high-quality remote critical care to patients in the intensive care units (ICU) of community hospitals. Through experienced clinicians, supported by cutting-edge telemedicine technology and a process improvement programme, Advanced ICU Care provides continuous ICU patient monitoring and improved care and safety outcomes to critically ill patients across the country. Hospital ICUs are linked with Advanced ICU Care's virtual ICU Operations Center in St. Louis, Missouri. through a technology platform developed by VISICU, allowing Advanced ICU Care's board-certified intensivists (critical care medicine physicians) and critical care nurses to monitor hospital ICU patients from a central location.

For more news on the same subject, you can also read this VMW issue's article Use of telemedicine for ICU patients not linked with improvement in survival.


Source: Advanced ICU Care

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