Approximately 5% of hospitalized patients end up in intensive care units (ICUs), accounting for 20% of overall hospital care costs.
ICUs are not only charged with caring for the sickest patients, but the care required is complex, fast-paced and necessitates streamlined cross-disciplinary collaboration. In a chaotic care environment where staff are inundated with data, it is often difficult to recognize when patients are ready to progress along care processes - such as being weaned off of mechanical ventilation.
Every extra day on a ventilator can lead to a longer length of stay for patients, as well as increased morbidity and mortality.
In partnership with a team led by Barry Fuchs, MD, we set out to develop and test an automated tool to monitor the status of ICU patients in real-time and prompt providers when action is needed – for example, when sedation can be weaned, or when a patient is ready for extubation.
We piloted the ICU Care Coordination Platform in the medical intensive care unit (MICU) at the Hospital of the University of Pennsylvania (HUP) with over 140 mechanically ventilated patients.
In a single view, providers were able to see ventilation and sedation status for all of their patients - enabling them to discuss care decisions before and during rounds. The system also kept the care team informed 24/7 by highlighting when a patient was ready to come off a breathing machine on the dashboard and via text message alerts.
Over the course of four months, patients enrolled in the pilot awoke and came off the ventilator sooner. We also saw a decrease in median ICU length of stay by 1.1 days and median overall hospital length of stay by 1.5 days.
Implemented across the health system, the platform is estimated to produce a cost savings of approximately 3 million dollars per year. In addition, the ICU capacity created by the system translates to adding five beds per year.
Based on the success of the pilot, we partnered with Data Science, Information Services, the eICU team, Penn Value Improvement, and the Critical Care Committee to expand use of the platform to every ICU in the health system. The ICU Care Coordination Platform is currently live at HUP, Pennsylvania Hospital, Penn Presbyterian Medical Center and Chester County Hospital.
Beyond vent weaning, there is potential for the platform to be used for other ICU care processes, a possibility the team plans to explore in the upcoming year.