transforming health care delivery through system integration of the resurrection eicu® program

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Insert logo Transforming Health Care Delivery through System Integration of the Resurrection eICU ® Program Becky Rufo DNSc RN CCRN Resurrection eICU Program Operations Director Resurrection Health Care, Chicago I DO NOT have any significant financial relationships that create, or may be perceived as creating, a conflict related to this educational activity. eICU ® is a registered trademark of Phillips-VISICU © 2010 Resurrection Health Care

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How Resurrection Health Care implemented a 24/7 specialized care system via centralized remote patient monitoring by intensivists that has reduced medical errors and ICU mortality, improved patient outcomes, saved costs plus enabled tracking of patient vital trends.

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Page 1: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Insert logo

Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Becky Rufo DNSc RN CCRNResurrection eICU Program Operations DirectorResurrection Health Care, Chicago

I DO NOT have any significant financial relationships that create, or may be perceived as creating, a conflict related to this educational activity.eICU® is a registered trademark of Phillips-VISICU

© 2010 Resurrection Health Care

Page 2: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

• The clinical impact on risk reduction, patient safety and quality.

•The operational and financial benefits of a virtual ICU.  

• Innovative utilization of the virtual ICU to enhance performance outcomes

Program Objectives

© 2010 Resurrection Health Care

Page 3: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

The virtual ICU provides an organizational and technology platform to transform critical care by redesigning the way critical care is structured and managed.

Optimizing core clinical operations using information technology to drive significant quality and financial improvements

Clinical Transformation

© 2010 Resurrection Health Care

Page 4: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Resurrection eICU® COR

Activated July 10, 2007• 182 critical care beds monitored• 14 ICUs, 7 Acute Care sites 1

LTACH

eRN/DA: 24/7 coverage

eMD: M-F

from 4PM to 6:00AM

Sat/Sun

from 11AM-6:30PM

© 2010 Resurrection Health Care

Page 5: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

© 2010 Resurrection Health Care

Page 6: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

More eyes, ears, enhanced care

© 2010 Resurrection Health Care

Page 7: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

• Patient safety and quality

• Leverage of technology to accelerate critical care delivery using an onsite/remote model

• Incorporates telemedicine communications, clinical information systems, decision-support tools.

• Incorporates best practice, standardization, clinical resource and workflow redesign

• Consistent reporting mechanism

Virtual ICU?Virtual ICU?

© 2010 Resurrection Health Care

Page 8: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

© 2010 Resurrection Health Care

Page 9: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Hospital Mortality for ICU Patients

Based on data collected from three ICUs pre and post eICU Program implementation, there was an overall 43% reduction in risk adjusted hospital deaths of ICU patients compared to the baseline period.

Q3 2008

All

Hospital Deaths

Hospital Deaths

Hospital Deaths

Hospital Deaths

Hospital Deaths

If at Pre Risk Adjusted Rate 443 97 124 112 109

Actual 254 60 78 62 54Savings 188 37 46 50 55

Percentage Reduction 43% 38% 37% 45% 50%

4 Quarter Total Q4 2007 Q1 2008 Q2 2008

© 2010 Resurrection Health Care

Page 10: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Hospital Standardized Mortality Ratio

0.00

0.20

0.40

0.60

0.80

1.00

1.20

Pre Q4 2007 Q1 2008 Q2 2008 Q3 2008

Act

ual

:Pre

dic

ted

All Units

© 2010 Resurrection Health Care

Page 11: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

ICU LOS ReductionCompared to baseline, the three ICUs had a combined reduction of 42% in risk adjusted ICU Days. This was a net savings of 6,171 ICU days over the 12 months.

Q3 2008

All ICU Days ICU Days ICU Days ICU Days ICU Days

If at Pre Risk Adjusted Rate 14,714 3,110 4,142 3,903 3,559

Actual 8,543 1,575 2,543 2,200 2,226Savings 6,171 1,535 1,599 1,704 1,333

Percentage Reduction 42% 49% 39% 44% 37%

Average Patient Days' Reduction 2.2 2.7 2.0 2.2 1.9

4 Quarter Total Q4 2007 Q1 2008 Q2 2008

© 2010 Resurrection Health Care

Page 12: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

ICU LOS Ratios

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Pre Q4 2007 Q1 2008 Q2 2008 Q3 2008

Act

ual

:Pre

dic

ted

All Units

© 2010 Resurrection Health Care

Page 13: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Hospital Mortality Extrapolation to Resurrection Health System

Over the course of the 12 months there were almost 500 fewer in-hospital deaths of ICU patients than predicted – a reduction of 39%.

Q3 2008

All

Hospital Deaths

Hospital Deaths

Hospital Deaths

Hospital Deaths

Hospital Deaths

If at Pre Risk Adjusted Rate 1,216 168 240 338 469

Actual 737 108 166 197 266Savings 479 60 75 140 204

Percentage Reduction 39% 36% 31% 42% 43%

4 Quarter Total Q4 2007 Q1 2008 Q2 2008

© 2010 Resurrection Health Care

Page 14: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

General Care Extrapolation to the Health System

Finally, there were 7,200 general care days fewer than predicted over the 12 months across the health system – a 17% reduction.

Q3 2008

All

General Care Days

General Care Days

General Care Days

General Care Days

General Care Days

If at Pre Risk Adjusted Rate 43,586 5,819 8,729 12,274 16,763

Actual 36,358 4,655 7,769 10,188 13,746Savings 7,228 1,164 960 2,087 3,017

Percentage Reduction 17% 20% 11% 17% 18%

Average Patient Days' Reduction 0.9 1.1 0.6 0.9 1.0

4 Quarter Total Q4 2007 Q1 2008 Q2 2008

© 2010 Resurrection Health Care

Page 15: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Transformational Strategies

Technology Operational

Clinical

FinancialElectronic documentation

Wireless carts

Multidisciplinary integrations

Mortality/ LOS

Standardization of:•Protocols•Best practice•Policies/Guidelines

Performance Measures/outcomesWorkflow redesign

ROI

Risk Reduction

© 2010 Resurrection Health Care

Page 16: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Information ServiceInformation Service

Respiratory Therapists & Respiratory Therapists & DietitiansDietitians

Cardiac RehabCardiac Rehab

Residents & Attending Residents & Attending PhysiciansPhysicians

Nurses & Student NursesNurses & Student Nurses

PhysiciansPhysicians

PharmacyPharmacy

ICU Managers / ICU Managers / DirectorsDirectors

MarketingMarketing

Medical Records Medical Records Dept. / CoderDept. / Coder

Finance DepartmentFinance Department

Risk / Claims / LegalRisk / Claims / Legal

Case Managers / Social Case Managers / Social WorkersWorkers

Executive Leadership TeamExecutive Leadership Team

Quality DepartmentQuality Department

ICUICU

Integration

New Care Delivery Model - Onsite and Remote Teams

© 2010 Resurrection Health Care

Page 17: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Driving Driving forces to forces to

IntegrationIntegration

Driving Driving forces to forces to

IntegrationIntegration IS and Clinical Partnership

APACHE/Benchmark Reports

Evidence-Based Practice

Clinical Resource

Standardization

Clinical Risk Reduction

Multidisciplinary Collaboration

Fast Track to Integration and Performance

Balanced Scorecard

National Recognition

Organizational and Executive Leadership Direction

Integration Model

Leveraging Innovation

© 2010 Resurrection Health Care

Page 18: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Why integrate an LTACH?

• Organizational direction to standardize ICU care across the health system

• Reduce ICU LOS• Integrate best practice

initiatives• Develop “ICU” concept• Improve utilization of

ICU beds• Prevent transfers from

LTACH to acute care

© 2010 Resurrection Health Care

Page 19: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Challenges in Implementing LTACH units

• Conceptual change to ICU• Technology use• Transition to electronic documentation• Standards in care• Best practice• Performance outcomes• Incorporate with Critical Care services

© 2010 Resurrection Health Care

Page 20: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Impact of Integration

Patient Safety/Quality

RetentionClinical Risk Reduction

StandardizationBest PracticeDocumentation

Clinical skills Critical ThinkingEfficiency

EnergizedPositive

Empowered

© 2010 Resurrection Health Care

Page 21: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Demonstrated Savings

• Reduced ICU LOS by 50%• Reduction in ICU and Hospital mortality• Hospital LOS reduced by 9.03 days • Substantial financial savings

© 2010 Resurrection Health Care

Page 22: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

2007-2009 Data

ICU Days Saved 9,241 $ 11.5 M *

Non-ICU Days Saved 18,517 $ 5.60 M *

Lives Saved 1090

Unit Stays 20,175

APACHE Scores 57.4 - 59.5

Consistent system ICUs mortality/LOS ratios< 1.0

(*) ICU metric $1250/day saved in labor & supply costs. Non-ICU metric $300/day saved in labor & supply costs.

LTACH 8 Bed ICU (first 4 months).

50% LOS reduction. $387 K

3% reduction in unplanned discharges. $72 K additional revenue

0.52 reduction in ICU mortality.

Highest RHC APACHE scores (73-78).

© 2010 Resurrection Health Care

Page 23: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

2008 and 2009 PhilipsVISICU eICU®

Impact Award recipient

© 2010 Resurrection Health Care

Page 24: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Best Practice Compliance: Q2 2009

Measure Metric Target Q109 Q209 Q309 Q409 All eICU Program Average: Q109

VTE Prophylaxis Compliance for At Risk patients

  > 90%

  80-90%

  < 80%

Stress Ulcer Prophylaxis Compliance for At Risk patients

  > 90%

  80-90%

  < 80%

Low Tidal Volume Ventilation

Compliance for ALI/ARDS patients

  > 75%

  50-75%

  < 50%

Blood Transfusion Threshold

Transfused PRBCs (hemoglobin < 7gm/dL)

  > 50%

  20-50%

  < 20%

Beta Blocker UseCompliance for at risk surgical &

ACS patients

  >80%

  60-80%

  <60%

Glycemic Control Average daily glucose < 150

mg/dL

  > 80%

  60-80%

  < 60%

ComplicationsIncidence of Acute Renal Injury /

patient stay

  < 1.3%

  1.3-1.6%

  > 1.6%

Ventilator Days Median ventilator days

  < 1.5

  1.5-2.0

  > 2.0

© 2010 Resurrection Health Care

Page 25: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

eICUeICU®®-ICU-ICUeICUeICU®®-ICU-ICUICU turnover

Reviewed quarterly

Quality: APACHE Report

RHC Quality Scorecard Data

Balanced ScorecardBalanced Scorecard

Monitors system wide trends

Drives clinical best practice

Vision and organizational direction

Quality :Benchmark Reports

eICU® MD Interventions

© 2010 Resurrection Health Care

Page 26: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Learning in the trenches Learning in the trenches

“Mistakes made on a small scale can be overcome. Mistakes made when you’re at the top cost the organization greatly and damage a leader’s credibility”.

“The difference between average people and achieving people is their perception of and response to failure”

J.C. Maxwell (2008). Go for Gold

“Mistakes made on a small scale can be overcome. Mistakes made when you’re at the top cost the organization greatly and damage a leader’s credibility”.

“The difference between average people and achieving people is their perception of and response to failure”

J.C. Maxwell (2008). Go for Gold

© 2010 Resurrection Health Care

Page 27: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

27© 2010 Resurrection Health Care

Page 28: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Longitudinal Mortality

28*APACHE IV predictions begin

© 2010 Resurrection Health Care

Page 29: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Longitudinal Length of Stay

29

* APACHE IV predictions begin

© 2010 Resurrection Health Care

Page 30: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

•EngagementVision

Leadership

Communication

Direction•Outcomes

Commitment

•VisibilityVulnerability

Value

© 2010 Resurrection Health Care

Page 31: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Skilled Communication• The virtual ICU identifies

communication and information barriers went unnoticed

• Lack of consistent and efficient communication #1 contributor to errors/ increased risk

Technology constraints

Paper

EMR

Funding

Fragmentation

Poor OrganizationalDirection

Lack of Vision

Poor Partnerships“Gaps”

AACN Standards for Establishing and Sustaining Health Work Environments

© 2010 Resurrection Health Care

Page 32: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Lessons Learned

• Establish your power base• Know the application• Know the organization• Know current performance

metrics• Know financial operations• Executive sponsor/leadership• Integrate organizational model• Establish ownership

© 2010 Resurrection Health Care

Page 33: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

National Safety Imperative

- IHI- JCAHO National Patient Safety Goals- CMS 2008 Complication Proposal- Health Care Reform, “Stimulus Proposal”- HIMSS- ATA - ACCP

© 2010 Resurrection Health Care

Page 34: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Clinical Risk Reduction

VS monitoring

Medication administration

Respiratory failure

QualitySafety$$$$$

Examples of Risk

Reduction

Pneumothorax

Perforated VISICU

Suicide

Falls

IV maintenance

Phlebotomy

Feeding Tube placement

Substance Abuse

QualitySafety$$$$

© 2010 Resurrection Health Care

Page 35: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Clinical Risk Reduction

• Partnership with Risk/Claims Management, Legal • Efforts to promote patient safety and quality• Medication errors• Standards of Care• Consistent communication of information• Procedure related• Complications• Equipment related

© 2010 Resurrection Health Care

Page 36: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Blood Transfusion Utilization (Hemoglobin >9-11 and > 11)

Goal: Reduction in blood administration for Hgb >9

Q4 2007: (3 sites): 29%

Q1 2008: (4 sites): 21%

Q2 2008: (6 sites): 17%

Q3 2008: (7 sites): 15%

Q4 2008: (8 sites): 17%

Q1-2 2009: 14%

0%

5%

10%

15%

20%

25%

30%

1

Q4 2007: (3 sites): 29%

Q1 2008: (4 sites): 21%

Q2 2008: (6 sites): 17%

Q3 2008: (7 sites): 15%

Q4 2008: (8 sites): 17%

Q1-2 2009: 14%

© 2010 Resurrection Health Care

Page 37: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

eICU® Nursing Interventions(Jan-July 2009, n=1653)

• 46% (SBP <80mmHg)• 20% Respiratory/Oxygenation• 13% Lab values & follow up• Best practice• Patient Safety

– Side rails down

– Device, tubing, IV, lead disconnect, equipment

– Medication variance

© 2010 Resurrection Health Care

Page 38: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

eICU® MD Interventions• # 1 Respiratory failure/airway

management• Hemodynamic (BP, HR)• Fluid / Electrolyte Imbalances• Sepsis/shock• Code management • Best Practice• Acute Renal Failure

© 2010 Resurrection Health Care

Page 39: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Routine Rounds Can Reveal Extraordinary Occurrences

Scenario 1

• In discussion with the patient, the patient reveals to the eICU nurse that he has had right arm pain since he had his blood drawn earlier in the morning.

• The eICU nurse was able to direct the

patient to lift up the sleeve of his gown. The eICU nurse is able to focus the camera in more closely on the patients arm to reveal a tourniquet in place from an earlier blood draw.

• The eICU nurse had the ability to collaborate with the primary care nurse by calling on the phone and describing the patient findings.

• While remaining focused on the patient, the

eICU nurse was able to witness the primary nurse removing the tourniquet from the patients arm.

Scenario 2

• Upon entering a patients room, the eICU nurse noticed the patient frequently wiping her nose.

• The eICU nurse asked the patient if she could offer her something for a ‘runny nose’. The patient denied a need for anything.

• As the eICU nurse continued her virtual rounds on the patient, she realized the patient was not wiping her nose with the tissue but in fact sniffing something from the tissue.

• The eICU nurse remained on camera with the patient but turned the volume off as she called the nursing unit on the phone and notified the primary care nurse on site of her findings.

• It was discovered that the patient was sniffing “HEROIN” which was leading to her exacerbation of asthma and elevated heart rate.

© 2010 Resurrection Health Care

Page 40: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Sometimes The Obvious is Overlooked

Scenario 1

• Sentry alerts revealed low pulse ox. readings on a patient

• The eICU nurse entered the room per camera and noticed a nurse at the bedside replacing the pulse ox. to the patient’s finger. A doctor was also listening to breath sounds as the patient visually displayed an increase in respiratory rate and difficulty breathing.

• The eICU nurse suggested an attempt to bag the patient and check ETT placement. However the primary nurse and physician ordered ABG’s and a portable CXR which would warrant a delay in obtaining results.

• In the meantime the patient heart rate started to brady down and the blood pressure was also unstable.

• The eICU nurse again suggested checking the ETT as she was calling a ‘Code Blue’.

• The primary nurse and doctor checked the ETT and noticed it was dislodged and in the patients mouth. Quick re-intubation led to prevention of loss of heart rate or blood pressure preventing a code situation.

Scenario 2

• Sentry alerts revealed a low blood pressure reading on a patient.

• The eICU nurse entered the room per camera to see the primary nurse administering a fluid bolus to the patient without improved BP results.

• While the primary nurse was beginning to administer pressors for BP support the eICU nurse was performing his patient rounds which included visualizing IV medicated drips.

• The eICU nurse noted the intubated patient to be on Propofol for sedation. The Propofol was at an unusually high rate. The eICU nurse and the primary nurse discussed the plan of care regarding BP control of the patient. After the primary nurse also recognized the Propofol rate to be unusually high, she decreased the rate, while maintaining sedation and

© 2010 Resurrection Health Care

Page 41: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Something to think about?

• Optimize clinical performance? • Redesign workflow processes?• Redundant documentation?• More effective daily rounding? • Communication breakdowns?• Increased clinical errors, “never events”• Educational needs?• Tracking outcome performance? Reporting

methods• Auditing staff performance?• Impact on budget? • Technology upgrades?• Regulatory requirements?

© 2010 Resurrection Health Care

Page 42: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

100,000 people awaiting organ donation100,000 people awaiting organ donation– 70,000 people awaiting kidney transplant70,000 people awaiting kidney transplant– 28,000 people are transplant recipients28,000 people are transplant recipients– < 2% of hospital deaths are medically < 2% of hospital deaths are medically

eligibleeligible

Responding to the needResponding to the need

© 2010 Resurrection Health Care

Page 43: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

• Virtual ICU MD collaborates with onsite team Virtual ICU MD collaborates with onsite team to provide emergent interventions required to to provide emergent interventions required to preserve organ function.preserve organ function.

• 84 year old donor gave life to young child84 year old donor gave life to young child

• June 2008 – present: Dramatic improvement June 2008 – present: Dramatic improvement in referrals (100% referrals at level 2 Trauma in referrals (100% referrals at level 2 Trauma center)center)

The difference of one call….The difference of one call….

© 2010 Resurrection Health Care

Page 44: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Resurrection System Key Metrics

24%34% 40%

61%81% 79%

90% 93%

2006 2007 2008 YTD 2009

Conversion Rate Timely Referral Rate

© 2010 Resurrection Health Care

Page 45: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

© 2010 Resurrection Health Care

Page 46: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Nursing Empowerment

eICU NurseRole definition

Scope of practiceCritical synthesis

LeadershipRole Model/Mentor

ICU NurseResourcesPartnership

Critical thinkingAvailability of data

Nursing StudentsClinical Rotation

Role modelLeadership

Nursing LeadershipAccountability

IS/Clinical partnership

© 2010 Resurrection Health Care

Page 47: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

AONE Guiding Principles for Future Care DeliveryThe Virtual and Presence Relationship of Care

• As technology advancements reframe the definition of presence, the patient remains at the center of care”.

• “Nurses of the future will value both virtual and presence-based caring”.

• “New & experienced nurses must be able to respond while working in virtual environments”.

• Technology Task Force Tool KitInformatics standardization, resource

• TIGER Initiative (Technology Informatics Guiding Education Reform), 2006Transform nursing education, practice into an automated information driven environment.

© 2010 Resurrection Health Care

Page 48: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Institute of Medicine (IOM) Statements on Quality

To Err is Human(2000)

Crossing the Quality Chasm

(2001)

Patient Safety, Achieving A New Standard of Care

(2003)

Patient Safety And

Quality Information systems,

Data standards,National infrastructure

are key to improvingPatient safety

© 2010 Resurrection Health Care

Page 49: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

IOM RecommendationsPatient Safety Data SystemsPatient Safety Data Systems• Capture patient safety information as a by-

product of care, provide immediate access to patient information and decision support tools.

Comprehensive Patient Safety ProgramsComprehensive Patient Safety Programs• Develop patient safety programs to

encompass case findings, analysis and system redesign

IOM Recommendations

© 2010 Resurrection Health Care

Page 50: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

So…What’s it like to the Operations Director?

© 2010 Resurrection Health Care

Page 51: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

© 2010 Resurrection Health Care

Page 52: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Keys to Success • Seek role model/mentor• Power is knowledge• Know subject matter• Scripting• Conceptual/theoretical approach • Practice • Reflection• People of influence

© 2010 Resurrection Health Care

Page 53: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

RHC eICU® Program2008 and 2009

IMPACT award recipient

NextGenWeb.org

© 2010 Resurrection Health Care

Page 54: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

© 2010 Resurrection Health Care

Page 55: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

Growth • Outreach• ED Integration• Tele-Neuro /Stroke• Tele-Health• Orientation/Mentoring

© 2010 Resurrection Health Care

Page 56: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

“The names of the patients whose lives we save can never be know. Our contribution will be what did not

happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and

wedding they would have missed, and that grandchildren will know grandparents they might never

have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have

been.” ~Donald M. Berwick, M.D.

© 2010 Resurrection Health Care

Page 57: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

“The names of the patients whose lives we save can never be know. Our contribution will be what did not

happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and

wedding they would have missed, and that grandchildren will know grandparents they might never

have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have

been.” ~Donald M. Berwick, M.D.

© 2010 Resurrection Health Care

Page 58: Transforming Health Care Delivery through System Integration of the Resurrection eICU® Program

© 2010 Resurrection Health Care

Feel free to contact me:

Rebecca Rufo DNSc RN CCRNResurrection eICU Operations DirectorResurrection Health [email protected]