Rush Memorial’s virtual ICU reduces transfers and improves the patient experience
Not long ago, Rush Memorial Hospital in Rushville, Indiana, did not have the ability to staff an ICU 24/7. Doctors and nurses could only provide part-time care in the ICU.
THE PROBLEM
This was something staff were looking at even before COVID as they considered what was best for their patients and their families when it came to being admitted to the hospital.
Additionally, the surgical staff was top of mind – without an ICU, surgeons were less likely to perform certain operations. When COVID came and staff were faced with the inability to transition, they knew it was time to do something different.
“Creating a traditional, personal ICU was not feasible for us because our hospitalists were on a seven-day rotation and because we were a small rural hospital, we only had two on staff,” said Carrie Tressler, RN, vice president nurse. at Rush Memorial Hospital. “Adding a full-time critical care intensivist just didn’t make sense to us.
“Additionally, attempting to have the two hospitalists perform intensive critical care at all hours of their shift would significantly increase the likelihood of burnout,” she added.
PROPOSAL
Rush Memorial engaged vendor Access TeleCare to implement a two-bed virtual ICU.
“We wanted to be able to open our ICU and have the intensivist/pulmonologist coverage available that our patients needed,” Tressler explains. “The additional support would allow our hospital staff to focus on caring for higher acuity patients without having to transfer them to another facility.”
MEETING THE CHALLENGE
The virtual ICU allows the virtual healthcare providers to communicate with patients via a telemedicine van. The HITRUST-certified telemedicine carts have full zoom-tilt cameras and integrated stethoscopes, so the virtual caregivers can get all the input they need to adequately care for the patient.
“The virtual ICU providers are available at night and take care of all admissions; in the morning they hand those patients over to our hospital physicians and then they are available for any guidance or questions that our on-site staff may have about those patients during the day .if they are round,” Tressler noted.
“The virtual ICU providers also work closely with our emergency physicians and anesthesiologists for these hands-on procedures to ensure smooth continuity of care as we transition to the virtual ICU,” she continued.
Access TeleCare providers also work closely with Rush Memorial’s nursing staff on education and training on operating the ICU and are always there to answer questions and provide guidance.
The hospital uses Cerner for its electronic patient file. The virtual doctors have access to the EHR to provide adequate care to patients and to create all necessary documentation.
RESULTS
Since deploying the virtual ICU, Rush Memorial has seen an increase in surgeries. The virtual ICU allowed surgeons to feel comfortable performing more surgeries knowing they had the clinical expertise to care for patients recovering in the ICU.
“We have seen a decrease in our transfers,” Tressler reported. “By enabling our care teams to care for more patients in intensive care after surgery, we have been able to reduce the number of transfers to other facilities.
“We have also improved our patient experience,” she continued. “A large portion of our patients are older and in the Medicare population, where we were concerned there would be an issue with virtual care. However, the feedback we have received has been overwhelmingly positive and they have enjoyed the virtual care.”
Having on-site nurses involved in the virtual visits and hospital staff showing patients around was helpful to the patient experience as it keeps a human element involved, she added.
“Additionally, having this virtual ICU has saved many patients and their families from being transferred to other facilities more than 60 miles away is one reason why patients are very happy with the virtual care,” she said.
ADVICE FOR OTHERS
The virtual ICU allows Rush Memorial surgeons to feel comfortable performing more surgeries knowing that clinical expertise is available to care for patients recovering in the ICU.
“If you are considering implementing a technology like this to provide the coverage you need in your hospital, I highly recommend it,” Tressler advised. “Just make sure you find a vendor who has done this before, who has the experience and expertise to help you set it up properly, and who has the flexibility to work with your existing workflows.”
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