Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort.

Autor: Dhala A; Houston Methodist Hospital, Houston, Texas, US., Fusaro MV; Equum Medical, New York, New York, US., Uddin F; Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US., Tuazon D; Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US., Klahn S; Department of Virtual Medicine, Houston Methodist Hospital, Houston, Texas, US., Schwartz R; Houston Methodist Hospital, Houston, Texas, US., Sasangohar F; Houston Methodist Academic Institute, Houston Methodist Hospital, Houston, Texas, US.; Texas A&M University, College Station, Texas, US., Alegria J; Houston Methodist Hospital, Houston, Texas, US., Masud F; Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US.
Jazyk: angličtina
Zdroj: Methodist DeBakey cardiovascular journal [Methodist Debakey Cardiovasc J] 2023 Aug 01; Vol. 19 (4), pp. 4-16. Date of Electronic Publication: 2023 Aug 01 (Print Publication: 2023).
DOI: 10.14797/mdcvj.1247
Abstrakt: A long-standing shortage of critical care intensivists and nurses, exacerbated by the coronavirus disease (COVID-19) pandemic, has led to an accelerated adoption of tele-critical care in the United States (US). Due to their complex and high-acuity nature, cardiac, cardiovascular, and cardiothoracic intensive care units (ICUs) have generally been limited in their ability to leverage tele-critical care resources. In early 2020, Houston Methodist Hospital (HMH) launched its tele-critical care program called Virtual ICU, or vICU, to improve its ICU staffing efficiency while providing high-quality, continuous access to in-person and virtual intensivists and critical care nurses. This article provides a roadmap with prescriptive specifications for planning, launching, and integrating vICU services within cardiac and cardiovascular ICUs-one of the first such integrations among the leading academic US hospitals. The success of integrating vICU depends upon the (1) recruitment of intensivists and RNs with expertise in managing cardiac and cardiovascular patients on the vICU staff as well as concerted efforts to promote mutual trust and confidence between in-person and virtual providers, (2) consultations with the bedside clinicians to secure their buy-in on the merits of vICU resources, and (3) collaborative approaches to improve workflow protocols and communications. Integration of vICU has resulted in the reduction of monthly night-call requirements for the in-person intensivists and an increase in work satisfaction. Data also show that support of the vICU is associated with a significant reduction in the rate of Code Blue events (denoting a situation where a patient requires immediate resuscitation, typically due to a cardiac or respiratory arrest). As the providers become more comfortable with the advances in artificial intelligence and big data-driven technology, the Cardiac ICU Cohort continues to improve methods to predict and track patient trends in the ICUs.
Competing Interests: Dr. Masud is a consultant for Teleflex and Astra Zeneca. All other authors have no competing interests to declare.
(Copyright: © 2023 The Author(s).)
Databáze: MEDLINE
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