Northwest Community Hospital Produces Better Patient Outcomes and Happier Physicians

When top management at Northwest Community Hospital in 2000 introduced an intensivist-led critical care program, the medical staff put up stiff opposition. The physicians even held meetings to see if they could force out Jay Cowen, MD and his team of intensivists.

Eight years later, major improvements in care and outcomes for critically ill patients have made physicians the biggest proponents of The Intensivist Group and its model of care. In a recent study by a consulting firm, the medical staff rated critical care as the highest quality service at the 500-bed, not-for-profit hospital in suburban Chicago and the second most important reason for referring patients there.

Building Trust

The intensivists got off to a slow start, with the medical staff insisting that critical care nurses not contact the critical care physicians directly when an intensive-care unit (ICU) patient was in trouble. Sometimes, they could not treat a patient until he or she coded. But the board-certified intensivists slowly won over the doctors by holding one-on-one meetings to explain their approach to critical care medicine as well as delivering immediate, state-of-the-art care to the patients.

At Northwest Community, The Intensivist Group applied the successful operating model that Cowen and his colleague Stephen Matchett MD, now chief medical officer for The Intensivist Group, had developed for Lehigh Valley Hospital’s ICU. Over time, it put in place a formal critical care program that included developing and rolling out standard order sets and protocols for everything from nutrition support to management of septic shock. In building these best practices, the intensivists drew on the expertise of Northwest Community’s medical and hospital professionals. They also began doing daily rounds as a multi-disciplinary team, led by the Intensivist Group.

Better Care at Lower Cost

In the first year at the hospital, the intensivists consulted on fewer than 10 percent of ICU cases. By 2004, the total had climbed to nearly 70% and now, they treat virtually all critically ill patients in the 36-bed ICU.

Northwest Community began seeing benefits within the first year. Critical care patients treated by intensivists spent one-third less time on ventilators and the average length of stay (LOS) for ventilated patients treated by intensivists fell to 3.7 days, nearly half the LOS for other ICU patients. What’s more, mortality has declined significantly. In fact, a large benchmarking study that compared hospitals found that Northwest Community’s mortality rate put in among the lowest three ICUs of similar size.

Importantly, The Intensivist Group’s operating model drove down costs as it was driving up effectiveness. By reducing the number of critically ill who developed septic shock and the costs associated with sepsis treatment, the intensivist program was saving the hospital more than $1.2 million a year.

“The Intensivist Group has helped us achieve our goal of making critical care a standout service and a major competitive advantage for our hospital,” says Dale Beatty, chief operating officer for Northwest Community. “Its focus on collaboration and best practices results  in better continuity and coordination of care, which in turn has driven major gains in quality, outcomes and savings. The intensivist model is even a recruitment and retention tool for us since our nurses and other health professionals really enjoy the multi-disciplinary, whole-patient approach to care.”

Greater efficiency and better care in the ICU leads not only to higher doctor and hospital staff satisfaction but more satisfied patients as well. In patient satisfaction surveys, Northwest Community patients rate their interactions with The Intensivist Group almost 6% higher than other physicians and their overall care in the ICU at an extraordinary 94%.