ICUs are currently viewed as a critical, yet expensive, component of hospitals. However, with a shift in mindset and approach, critical care programs can become strategic assets to their facilities.
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OLD PARADIGM
A templated and siloed approach
NEW PARADIGM
A holistic and interconnected approach
Operational Assessments
- General overview of program size and scope
- Questionnaire about performance data, operations, credentialing, and scheduling
- In-depth questionnaire
- Dialogue with clinical and ancillary teams
- Onsite collaborative rounding for real-time discover
- Dynamic goal setting
- Validating data abstraction
Staffing
- Fractional ICU coverage
- Reliance on short-term staffing (i.e. locums)
- Lack of consistent specialized training or support
- Inadequate level of scope and support for APPs
- 24/7 intensivist-led care
- Optimized physician and APP coverage
- Integrated telemedicine
- Specialty training for clinical staff
Access
- Disjointed communication and clinical care
- Increased ICU hold times in the ED
- Delayed transfers out of the ICU
- Geographical barriers to intensivist expertise
- Strong medical director presence and leadership
- Utilized admission and discharge criteria
- Targeted care when and where it is needed
- Keeping patients closer to home
With the shift to the new paradigm, the entire hospital experiences multiple benefits to cost and quality metrics.
Quality
- Enhanced interdisciplinary communication and collaboration
- Decreased ICU and inpatient mortality and length of stay
- Increased throughput into and out of ICU
Costs
- Cross-subsidizing of costs and impacts
- Integrated staffing coverage
- Decreased staffing turnover and increased retention
- Increased documentation accuracy
- Increased CMI for reimbursement
