Better ICU Management Improves Outcomes and Costs

The Intensivist Group provides state-of-the-art management of intensive care units that dramatically reduces mortality and complications for patients and improves financial outcomes for hospitals. It also enhances compliance with established guidelines for ICU care such as those published by the Leapfrog Group.

Our intensivist-led model has proven successful in both in-hospital settings as well as through off-site management, where our critical care physicians use innovative technology to remotely monitor critically ill patients and direct their bedside care.

On-Site Management

We start by staffing hospital ICUs with a team of board-certified intensivists. In addition to caring for patients, our intensivists create and institutionalize evidence-based protocols and standardized order sets to cover a broad range of clinical issues.

To do so, we work closely with physicians and other members of the hospital staff, including representatives from nursing, pharmacy, discharge planning, nutrition support, pastoral care, and respiratory and physical therapy. We also collectively establish key measures of performance, such as days on mechanical ventilation and length of stay, and set targets with dates for achieving the goals.

The team, along with members of the medical staff, meets regularly to review the protocols’ effectiveness and other issues. In addition, the intensivists lead daily, multidisciplinary rounds.

This approach measurably increases doctor and patient satisfaction, significantly improves care and outcomes and drives cost savings. Results at ICUs managed by The Intensivist Group include:

• In the first six months at Mercy Fitzgerald Hospital, length of stay fell by a half-day, resulting in annualized savings of nearly $1 million.
• At Northwest Community Hospital, patients rated the overall ICU care at 94%.
• Medical staff at Northwest Community rated critical care as the highest quality service at the hospital and the second most important reason for referring patients there.
• Mercy Philadelphia Hospital’s mortality rate for critically ill patients has decreased from 11.7 percent to 7 percent, which means one additional life is saved for every 21 ICU admissions.
• Length of stay has shrunk from 3.74 days in 2003 to 3.02 days in 2007 at Mercy Philadelphia Hospital, creating 1,227 additional ICU bed days and saving the hospital $850,000 annually.
• Mercy Fitzgerald’s ICU relative mortality rate declined from 16.1 % to 11.9% in just six months.

Telemedicine

Critical access and rural hospitals are finding that technology is allowing them to reap the benefits of an intensivist-led model of critical care. With a team of critical care physicians and nurses located at a monitoring center, the Intensivist Group provides round-the-clock care for a health system’s sickest patients, regardless of their location.

Once a health system establishes a centralized monitoring site and invests in the technology to connect all of its hospitals, The Intensivst Group helps bedside clinicians watch over the critically ill and prioritize and guide interventions. We don’t replace the in-hospital team; rather, we provide an additional and immediate level of expertise and experience in treating the critically ill.

As with our in-hospital management of ICUs, we establish uniform, evidence-based order sets and protocols. And we set improvement goals, such as lowering septic shock deaths, then track and report our progress.

On a day-to-day basis, our intensivists, critical care nurses and data specialists continuously monitor vital signs and other physiologic trends. With real-time information, we detect emerging complications or other problems early on and work with the in-hospital team to make appropriate changes to the care plan.

Depending on the hospital system, we are connected to patients and bedside teams by voice, video and data. Videoconferencing in each ICU room allows our intensivists to see and speak with patients and care teams as needed.