Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort.
burnout
cardiac ICU
cardiothoracic ICU
cardiovascular ICU
critical care
patient outcomes
predictive medicine
staffing
tele-critical care
Journal
Methodist DeBakey cardiovascular journal
ISSN: 1947-6108
Titre abrégé: Methodist Debakey Cardiovasc J
Pays: United States
ID NLM: 101508600
Informations de publication
Date de publication:
2023
2023
Historique:
received:
18
04
2023
accepted:
12
06
2023
medline:
8
8
2023
pubmed:
7
8
2023
entrez:
7
8
2023
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 37547898
doi: 10.14797/mdcvj.1247
pmc: PMC10402825
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4-16Informations de copyright
Copyright: © 2023 The Author(s).
Déclaration de conflit d'intérêts
Dr. Masud is a consultant for Teleflex and Astra Zeneca. All other authors have no competing interests to declare.
Références
Telemed J E Health. 2014 Oct;20(10):936-61
pubmed: 25226571
Crit Care. 2016 Jun 25;20(1):153
pubmed: 27342573
Digit Health. 2023 Jan 9;9:20552076221149529
pubmed: 36644663
Methodist Debakey Cardiovasc J. 2018 Apr-Jun;14(2):134-140
pubmed: 29977470
Methodist Debakey Cardiovasc J. 2018 Apr-Jun;14(2):126-133
pubmed: 29977469
Crit Care. 2022 Mar 22;26(1):75
pubmed: 35337366
BMJ Qual Saf. 2021 Sep;30(9):715-721
pubmed: 33028659
Crit Care Nurse. 2020 Aug 1;40(4):25-31
pubmed: 32464662
J Am Coll Cardiol. 2019 Apr 9;73(13):1726-1730
pubmed: 30947926
PLoS One. 2021 Sep 7;16(9):e0257003
pubmed: 34492062
Int J Environ Res Public Health. 2021 Oct 30;18(21):
pubmed: 34769948
J Am Coll Cardiol. 2020 May 19;75(19):2483-2517
pubmed: 32204958
CJC Open. 2022 Jun 18;4(9):763-771
pubmed: 36148250
Crit Care Med. 2020 Apr;48(4):553-561
pubmed: 32205602
J Med Internet Res. 2020 Sep 3;22(9):e20143
pubmed: 32795997
NPJ Digit Med. 2020 Feb 6;3:17
pubmed: 32047862
Crit Care. 2019 Jan 10;23(1):7
pubmed: 30630492
J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt A):2700-2706
pubmed: 34906383
Crit Care Med. 2019 Apr;47(4):550-557
pubmed: 30688716
ATS Sch. 2022 Nov 11;3(4):522-534
pubmed: 36726709
J Intensive Care Med. 2020 Jul;35(7):672-678
pubmed: 29806509
Clin Chest Med. 2022 Sep;43(3):529-538
pubmed: 36116820
Crit Care Med. 2016 Feb;44(2):441-2
pubmed: 26771788
JAMA. 2009 Dec 23;302(24):2671-8
pubmed: 20040555
Chest. 2014 Mar 1;145(3):500-507
pubmed: 24306581
Chest. 2013 Jan;143(1):19-29
pubmed: 22797291
Ann Am Thorac Soc. 2018 Jul;15(7):787-790
pubmed: 29727197
Am Psychol. 2018 May-Jun;73(4):468-477
pubmed: 29792461
Methodist Debakey Cardiovasc J. 2021 Dec 15;17(5):31-42
pubmed: 35855452
Am J Respir Crit Care Med. 2019 Apr 15;199(8):970-979
pubmed: 30352168
Crit Care Med. 2019 Apr;47(4):501-507
pubmed: 30688718
Cardiol Rev. 2017 May/Jun;25(3):97-101
pubmed: 28379901
J Family Med Prim Care. 2019 Jul;8(7):2328-2331
pubmed: 31463251
J Intensive Care Med. 2017 Feb;32(2):116-123
pubmed: 26768424
Chest. 2021 Apr;159(4):1445-1451
pubmed: 33127432
Crit Care Explor. 2020 Oct 23;2(11):e0271
pubmed: 33134956
World J Surg. 2001 Nov;25(11):1438-48
pubmed: 11760748
J Intensive Care. 2017 Dec 22;5:72
pubmed: 29299313
J Clin Monit Comput. 2017 Apr;31(2):261-271
pubmed: 26902081
Chest. 2016 Aug;150(2):314-9
pubmed: 27048869
Front Artif Intell. 2022 May 31;5:876007
pubmed: 35711617
Telemed J E Health. 2021 Mar;27(3):261-268
pubmed: 32809920
PLoS One. 2021 May 14;16(5):e0251779
pubmed: 33989358
Circulation. 2020 Dec;142(22):e379-e406
pubmed: 33115261
Crit Care Med. 2006 May;34(5):1297-310
pubmed: 16540951