Fall 2009 Newsletter

What's New

High Point Regional Health System rolls out Advanced ICU Care program

Advanced ICU Care has begun monitoring 20 ICU beds and two coronary care unit beds at High Point Regional Hospital in High Point, N.C., adding to the bedside care that patients already receive. The hospital is also utilizing mobile technology to provide critical care support and assist in the evaluation and care of critical patients outside of the ICU, such as the emergency room.

Using telemedicine technology, the program allows Advanced ICU Cares intensivists and critical care nurses ― located at the companys Operations Center in St. Louis, Mo. ― to monitor critically ill patients around the clock, in collaboration with High Points local medical and nursing staff.

"This technology adds an extra layer of coverage -- an extra safety net -- to what we're already doing," said Dr. Peter Brath, ICU medical director at High Point Regional.

For more on the new technology at High Point Regional, click here.

St. Marys Health Center and Advanced ICU Care to present at IHI National Forum on Quality Improvement in Health Care

St. Marys Health Centers Vice President of Medical Affairs John D. Lucio, D.O., along with Advanced ICU Cares Isabelle Kopec, M.D., will be presenting at the IHI National Forum on Quality Improvement in Health Care, to be held from December 6 - 9 in Orlando, Fla. Their presentation, titled Preventing the Preventable, will focus on the quality improvement program that is part of the virtual ICU at St. Marys.

Dr. Lucio and Dr. Kopec will share some of the quality improvements in areas such as ventilator-associated pneumonia, glucose management and others, as well as the team approach used in securing these results.

To learn more about the IHI 21st Annual National Forum on Quality Improvement in Health Care, click here.

Our People

New team members join Advanced ICU Care

Advanced ICU Care welcomes two new team members. Patty Frasca, RN and Shelley Meyer, BAS, BSN, CCRN, have joined Advanced ICU Care as Clinical Operations Leads.

Shelly came to Advanced ICU Care from St. Marys Health Center where she worked as a critical care ICU nurse for four years. Shelley has a double bachelors degree -- behavioral sciences and nursing. Her degree in behavioral sciences expounded career opportunities as a research biochemist/biologist. During her research career, Shelley was involved with several significant projects of which two involved co-authorship on two publications in national biology journals; Journal of Cell Biology and Diabetes.

Patty Frasca has deep ICU experience coupled with a strong background in management within the SSM system at St. Josephs Hospital in St. Charles, Mo. During her career, Patty was responsible for the extensive growth of the cardiac catheterization lab at St. Josephs Hospital over a seven year period and successfully achieved a 90 percent retention rate with the nursing staff during her supervision of the lab. Patty not only brings her years of management experience, but also her aptitude for building strong teams and visualizing progress.

Please join us in welcoming Patty and Shelly to the Advanced ICU Care team.

Nurse Nook

Going paperless in the ICU

For many critical care nurses, the value of tele-intensivist programs like Advanced ICU Cares is clear. With remote intensivists and seasoned critical care nurses monitoring their patients 24/7, nurses have an informed specialist available to them at a moments notice. They no longer need to wait for a physician to return a page; instead, they have immediate support by Advanced ICU Care intensivists and nurses who are looking at the same patient data they are, at the same time.

This access to real-time patient care data is possible through the virtual ICU programs technology infrastructure, the eCareManager™. Offering a dashboard view of all key patient information, this technology gives remote clinicians the data they need to support local nurses. It also serves as the bedside caregivers electronic critical care record.

Featuring the same patient care plan and other patient data that is available to the remote team, the eCareManager is designed to have little or no impact on nursing flow. Nurses may use the technology to update the patient care plan, and much of this information is also used to create the nursing sign-out report at the end of a shift. This report facilitates coordination of care among nurses and physicians and provides an accurate and efficient exchange of information at the shift change.

Many nurses quickly embrace the electronic documentation, realizing the potential for real improvements in patient care and time saved. There can be a learning curve, and training normally requires between two and four hours. But once the program is underway, feedback is generally positive. Kristy Huenink, an ICU nurse at St. Marys Health Center in Jefferson City, Mo., said, "If there's something I've never encountered or have a question about, they're (Advanced ICU Care intensivists) always there. That improves what I can do for that patient."

In addition to the clinical information, the technology also includes remote care tools, such as cameras and videoconferencing, which allow Advanced ICU Care physicians and nurses to see and communicate directly with patients, families and the bedside care team. The system also provides automated alerts, which identify potential patient problems and allow physicians to intervene earlier.

The Bottom Line

The intensivist-hospitalist team

In an ideal environment, many hospital ICUs would have intensivists available around the clock, ensuring 24/7 specialist care for their sickest patients. Intensivist-directed care, which uses a high-intensity, multi-disciplinary approach, has been proven to have meaningful results in the ICU. According to the Leapfrog Group, hospital mortality rates fall by as much as 30 percent and ICU mortality rates decline 40 percent when ICU patients are managed or comanaged by board certified intensivists.

Unfortunately, ever-growing intensivist shortages can make intensivist-directed teams hard to come by. The Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS) has predicted a 22 percent to 35 percent shortfall of needed intensivists by 2030. But hospitals are finding ways to work around these shortages, developing new approaches to ICU care that include intensivists, hospitalists and telemedicine.

Ministry Healths Saint Clares Hospital in Weston, Wis., has implemented a team approach to managing ICU patients, where in-house hospitalists work alongside Advanced ICU Cares 24/7 intensivists through virtual ICU technology. Saint Clares hospitalists drive patient care plans and often take care of daily issues, while tele-intensivists in St. Louis monitor patient care data around the clock. Through the technology program, tele-intensivists can tune in to subtle changes in a patients condition and uncover potential problems before they develop further.

Working together, on-site hospitalists and remote intensivists can also help provide continuity of care from the emergency room to the ICU. For example, hospitalists can start patient protocols in the emergency room, knowing that the intensivist from St. Louis will carry them forward with the patient.

Parkview Health in Fort Wayne, Ind., has also designed an intensivist-hospitalist program. Its program was designed to increase the amount of bedside support hospitalists provide and expand their in-patient coverage, while providing 24/7 intensivist monitoring and support. As part of this local program, Advanced ICU Cares intensivists and critical care nurses provide around-the-clock monitoring for Parkview Health ICU patients, supporting the systems local intensivists, hospitalists and other physicians and nurses in the ICU.

In both hospitals, 24/7 monitoring by board certified intensivists means that hospitalists and other physicians supporting the ICU can feel assured that their patients are covered, even when they are not there. The support can free them up to care for other patients within the ICU or elsewhere in the hospital. At the same time, this level of support allows community hospitals to keep critically ill patients rather than transfer them, benefiting both the patients family as well as the hospitals bottom line.

eICU is a registered trademark of Visicu, Inc.