0
Education, Research, and Quality Improvement |

Workload Update on the Most Rural Tele-Intensive Care Program

Edward Zawada*, MD; Srinivas Gangineni, MD; Pat Herr, CCRN; Michael Heisler, MD; Scott Deppe, MD; Avera eServices Research Group
Author and Funding Information

Avera McKennan Hospital & University Health Center, Sioux Falls, SD


Chest. 2012;142(4_MeetingAbstracts):548A. doi:10.1378/chest.1384421
Text Size: A A A
Published online

Abstract

SESSION TYPE: Outcomes/Quality Control Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Our tele-intensivist program has been operating for 90 months and is considered the most rural of similar programs across the nation, serving 32 hospitals in 6 mostly sparsely populated North Central states in the upper Midwest. We have previously published reduction in ICU/hospital mortality and reductions in ICU/hospital length of stay after initiation of this service which has translated to increased throughput. As an example, the program covers 132 beds at capacity, but the average census has been 59.2 beds per day over the past 6 months despite the high number of daily admissions of 22.1 per day. Our program has had the highest number of interventions per month of all the eICU programs at an average of 1213 each month for the last 6 month period. This high number reflects the high demand for our interventions by our subscribing hospitals.

METHODS: After each order was written, the Intensivist scored the intervention as major, intermediate, or minor. The top five most numerous major interventions are shown in Table 1.

RESULTS: Table 1 (1360 Interventions) Electrolyte management 8% (including hyper/hypokalemia) Respiratory failure management 7.8% Shock 7.6% Hypoxemia 6.8% Hypotension 6.7% The top 5 intermediate interventions are shown in Table 2, and finally, the top minor interventions are shown in Table 3. Table 2 (3012 Interventions) Communication with families and providers 25.7% Electrolyte management 14.4% Hypotension 7.5% Diagnostic test evaluation 7% Arrhythmia management 5.6% Table 3 (1178 Interventions) Communication 60.7% Electrolytes 14.2% PRN meds 8.1% Agitation control 5.3% Ordering tests 4.8%

CONCLUSIONS: It can be concluded that tele-intensive care is an active, welcomed, and needed service in the rural setting. Electrolyte management is a common intervention which has in recent literature been shown to be an important factor in outcome of acute illness such as abnormal potassium levels in acute myocardial infarction.

CLINICAL IMPLICATIONS: The welcome, frequent interventions we believe are an important factor in our previously published improved quality measures and outcomes in rural hospitals.

DISCLOSURE: The following authors have nothing to disclose: Edward Zawada, Srinivas Gangineni, Pat Herr, Michael Heisler, Scott Deppe, Avera eServices Research Group

No Product/Research Disclosure Information

Avera McKennan Hospital & University Health Center, Sioux Falls, SD

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Topics

workload

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543