Four Georgia Hospitals lead the way in patient outcomes, unit efficiency

From VHA Georgia

By Donya Hengehold

Recognizing the many challenges facing hospital ICUs ― from the shortage of critical care physicians, to the increasing number and severity of patients, to mounting financial pressures ― VHA Georgia partnered with tele-ICU provider Advanced ICU Care to help address these headwinds and provide compelling clinical and financial opportunities for its members.

Four VHA Georgia hospitals ― Houston Medical Center, Warner Robins, Ga., Perry (Ga.) Hospital, Satilla Regional Medical Center, Waycross, Ga., and Tift Regional Medical Center, Tifton, Ga,, ― are working with Advanced ICU Care to bring around-the-clock evidence-based care and advanced technology to improve patient care outcomes and financial performance.

Numerous studies have shown that well run tele-ICU programs lead to significant reductions in ICU patient mortality, length of stay and complications. In a recent study completed by NEHI and the Massachusetts Technology Collaborative, hospital ICUs reported:

• 20% mortality reduction in the midst of increasing acuity
• 30% length of stay reduction
• 20% decrease in the average cost per case
• 23% average increase in patient retention rate (avoiding transfer outs)
• An average improvement in the contribution margin of over $2,500 per ICU admission
• The tele-ICU paid for itself in the first year

The study concludes that, "the clinical and financial benefits of a fully implemented tele-ICU system offer a win-win-win opportunity for patients, hospitals and payers across Massachusetts."

Early patient outcome results at Houston and Satilla illustrate findings similar to those in the NEHI study. For example, Houston Medical Center, which started its tele-ICU program in its 18-bed ICU in late 2009, has already seen ICU patient mortality fall 17% below predicted mortality, and ICU length of stay drop by more than 30%. At Perry Hospital, data suggests that the actual mortality rate is 64% less than the predicted mortality rate after one year.

The tele-ICU program allows patients to stay in their local community and receive the best possible care, with 24/7 monitoring by experienced critical care physicians and nurses. This change resulted in a 9% increase in ICU patient volume within the first year at Perry and improved unit margins.

The adoption and standardization of evidence-based best practices in the ICU are keys to achieving results such as these. Using the tele-ICU technology's automated reminders and decision support tools, plus collaboration among local staff and the Advanced ICU Care clinicians, best practices in areas such as sepsis management, ventilator-associated pneumonia prevention, glucose management and many others have been realized.

Gail Moore, RN, director of critical care services at Satilla Regional, explains, "The program gives us more eyes, ears and resources to offer patients the best practices in critical care medicine. This advanced technology does not replace the on-site physician or caregivers; it just enhances the safety and care we offer our patients."

Tift Regional Medical Center recently went live with the Advanced ICU Care program in its 20-bed ICU. "With the assistance of Advanced ICU Care, the co-management of the critically ill produces another layer of care that we believe will result in improved patient outcomes, reduced complications and reduced lengths of stay in the ICU. Thus, we will get patients home sooner and more safely to their families," says Bill Guest, MD, chief medical officer of ICU at Tift Regional.

Advanced ICU Care clinicians have become integral members of the ICU team's at all four hospitals, working closely with medical staff, nurses and committees to optimize care in the ICU and deliver the very best to patients. George Wheeler, MD, family practitioner at Blackshear Family Practice, agrees.

"Patients in our critical care unit have immediate, real-time access to expert medical providers through the Advanced ICU program. The availability of this technology is revolutionizing the care we are able to provide our critical care patients," Dr. Wheeler says.

Tele-ICU programs also provide a competitive advantage for physician recruitment efforts. Raymond Moreno, MD, vice president of medical affairs at Tift Regional says, "I was unsure of how effective this program would be in helping our recruiting efforts, but after months of hitting a dry well we have seen renewed success with our recruiting because of this program. Recruits see this as a valuable clinical resource and a lifestyle improvement."

Overall the tele-ICU program:

• Enhances patient care through best practices
• Improves access to intensivist care and advanced technology
• Supports clinical teams
• Leverages quality improvements to improve unit efficiencies and reduce costs

Already, patient care outcomes at Houston Medical Center, Perry Hospital, Satilla Regional Medical Center and Tift Regional Medical Center have improved and within these communities, patients, families and staff, see every day what the best possible care looks like.

Copyright 2011 VHA Inc. All Rights Reserved.