Written by Lou Silverman, CEO, Advanced ICU Care | January 5, 2016.
Originally appeared on Health IT Outcomes
The Case For Tele-ICU
Hospital intensive care units (ICUs) represent a microcosm of the interesting challenges present in today’s healthcare ecosystem – balancing the increasing demand for healthcare services with the increasing costs of those services. As baby boomers age, there is a large and growing population that requires critical care; however, the resources available to treat them – physicians trained in critical care, or intensivists – are increasingly spread thin. While ICUs represent approximately 10 percent of hospital beds, they account for nearly 30 percent of its costs. Consequently, an ICU’s ability to treat patients not only effectively, but efficiently, is intricately tied to the hospital’s overall performance.
As the supply of intensivists remains stagnant and the expense to recruit and retain them increases, hospitals are looking outward to bridge the gap between manpower and providing care that aligns with best practices. Tele-ICU continues to emerge as a proven, viable solution, presenting documented cases of clinical, operational and financial benefits. The growing number of hospitals evaluating a tele-ICU must first thoughtfully consider the selection of a tele-ICU partner, and then with that partner, collectively establish program goals and develop clinical best practices to achieve optimal outcomes for all stakeholders.
Evaluating Tele-ICU Partners
The selection of a tele-ICU partner is similar to the evaluation of other strategic partners, comprising of a comprehensive review of the candidate’s experience, capabilities, and alignment with internal client hospital priorities. A number of data points will combine to create a clear picture of the potential partners’ experience; the number of facilities with which they work, the quality and timeliness of implementations, the partner resources available to support the ongoing relationship between the bedside and tele-ICU teams, a strong and growing tele-ICU clinical team, and the availability of strong references.
The potential tele-ICU partner should exhibit extensive and sustainable support and guidance capabilities, honed through experience, to drive clinical, operational and financial outcomes. At the forefront of the tele-ICU service is a distinguished and experienced team of critical care-trained/certified intensivists, advanced practice providers and nurses. These clinical experts are supported by an infrastructure that includes a clinically oriented client services team, a robust technology team and technology backbone and an expert data/analytics team. At a minimum, the proper data safeguards must be in place, but a meaningful value-add is the ability to provide and interpret data in such a way that provides actionable insight on performance metrics.
Successful Collaboration and Integration
Communication and collaboration provide a firm foundation upon which to build
a tele-ICU partnership that will drive optimal patient, operational and financial outcomes. First, and most important to productive tele-ICU collaboration, is that all parties agree on the value proposition that a tele-ICU program is expected to bring your hospital. It is imperative to jointly identify and prioritize goals with your tele-ICU provider. Then, you must communicate the agreed-upon value proposition and the process to relevant internal and external stakeholders. Clear and transparent dialogue is vital to not only implement a new program, but to foster a collaborative relationship between the two clinical teams which will, in turn, drive outcomes.
A key to managing expectations and managing for success is jointly establishing, and committing to, a timeline. Your tele-ICU partner should be able to guide the creation of a timeline based on their extensive experience and should help in orienting your key internal teams. Throughout the process, including post-go live, communication and interaction between both organizations should remain consistent and involve key functional groups, such as clinical, IT and operational teams. These teams, as well as clinical and executive leadership, should review jointly owned and actionable data on a regular and ongoing basis in order to design, prioritize and implement initiatives that further align with best practices.
Elevating Outcomes, Operations and “Return on Partnership”
Active and involved co-management by both parties once the tele-ICU partnership goes live will serve as a catalyst for improved patient outcomes, streamlined operations and maximized return on partnership. Together with your tele-ICU partner, you will establish and integrate incremental initiatives and identify targets for those initiatives that will enable you to achieve the goals you jointly established during the implementation process. Regular, collective review of ICU performance metrics will determine progress of and steer adjustments to current initiatives as well identify opportunities for continued improvement.
The constant and collaborative focus of a tele-ICU partnership on better patient care and operations in the ICU drives enhanced best-practice compliance, which in turn, induces improved patient outcomes as typically evidenced by reductions in patient mortality, length of stay, ventilator days, and ICU readmissions, along with potential increases to unit Case Mix Index and increases in bedside staff satisfaction and retention. These are, after all, the ICU’s clinical bottom line.
Conclusion
The growing adoption of tele-ICUs by hospitals nationwide is a testament to the proven ability of tele-ICU solutions to deliver improved patient outcomes and alignment with clinical best practices. This ability to deliver has been proven in hospitals of all sizes and types and across a widely varying spectrum of bedside ICU staffing models.
When a hospital identifies a strategic partner, it is important to consider the partner’s experience, capabilities and how effectively the two organizations can collaborate. Furthermore, a potential tele-ICU partner should specifically be judged on the resources they make available to deliver exceptional clinical, technical and client services. Satisfied, referenceable clients who have experienced improvements in patient outcomes and bedside staff retention and satisfaction are the ultimate proof point.
