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Remote Control Specialists are running intensive-care units from remote sites via computers, and at least one health system with the eICU® is reaping financial rewards — and saving lives. February 25th, 2002 How much is it worth to reduce deaths and complications in the notoriously error-prone intensive-care unit of any hospital? For David Bernd, president and chief executive officer of six-hospital Sentara Healthcare, it was at the very best a break-even proposition. If the Norfolk, Va.-based healthcare system could cover its costs on any investment aimed at reducing mortality in the ICU – plus increase doctor satisfaction and improve efforts to recruit and retain ICU nurses – then "it would be a home run," he says he told his medical team.
To that end, Sentara began wiring its ICU beds to a remote office in an industrial park eight miles away from 478-bed Sentara Norfolk General Hospital. The idea was to add an extra layer of around-the-clock ICU vigilance through a combination of software, hardware and a critical-care specialist working the remote controls. The results of that effort, which began 18 months ago, are just now coming in. An analysis by Cap Gemini Ernst & Young found a 25% reduction in the hospital mortality rate for Sentara Norfolk’s ICU population. That translates to approximately 60 lives saved per year, meaning at least one person a week who might otherwise have died at Norfolk General returns home safely. And that ultimate achievement in quality of care not only broke even but also paid dividends: an annualized net financial benefit of $3 million after subtracting all program costs. The report was commissioned by VISICU, the Baltimore-based company that developed the so-called eCareManager™; system installed at Sentara. The analysis covered more than 600 patients discharged from 16 ICU beds during the first half of 2001. Those results were annualized and compared with data on patients who were discharged during the 12 months before the program’s implementation. The eye-popping decline in mortality rates sent everyone back to check their math. "These were real saved lives, so it was pretty powerful," says Rod Hochman, M.D., Sentara’s senior vice president and chief medical officer. "For each week, someone was walking out of the Sentara System who wouldn’t have without the (remotely run) system." In addition, the average length of stay for critically ill patients, both in the ICU and in subsequent recovery on a nursing floor, was reduced by 17%. As a result bed turnover increased by 20% in the over-taxed ICU. The study covered 10 beds in the hospital’s general ICU and another six beds in a vascular ICU. In all, Sentara has 50 beds wired into the remote monitoring site – called an eICU® – at four ICUs in three of its six hospitals. The average stay in Norfolk General’s ICU declined to 4.36 days from 5.19 days. In the vascular ICU, stays declined to 2.43 from 2.92 days. The improved efficiency in the ICU had a domino effect on the general
hospital floor as well. Once patients were moved out of the general
ICU, they stayed in the hospital an average 9.1 days, down from
the previous 10 days. For vascular patients, the stays were trimmed
a full two days on the floor, to 6.5 days from 8.5 days. There was
no change in the average severity of illness in the unit. Page 1 of 4 | NEXT > |
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