Expand the ICU with a combination of beds and regular beds managed by the bedside and remote ICU monitoring

Instruction Details

Topic: USF Health System – Remote ICU Expansion 

Task:

Prepare content for an 18- to 20-slide PowerPoint presentation with extensive speaker notes.

As you prepare the business case, there are several options to consider:

1. Subscribe to remote ICU monitoring services with a per-usage model so that you only pay for services as they are rendered.
2. Expand the ICU with a combination of beds and regular beds managed by the bedside and remote ICU monitoring.
3. Expand the ICU with ICU rooms managed by bedside teams.
4. Expand the ICU and subscribe to remote ICU monitoring for rooms serving patients with more severe conditions.

Case Study:

USF Health System (USFHS) is a 500-bed hospital built to serve a suburban community of one million residents. Fifty beds are in the intensive care unit (ICU). Over the past 10 years, the community has grown to over one million residents supported by UMHS and four urgent care facilities. With the urgent care facilities able to address many of the population’s non-emergency issues, there is an increase in the ratio between the hospital’s non-ICU facilities and its ICU facilities. In a typical week, the ICU operates at 120% capacity, and 40% of patients experience a six- to eight-hour delay transferring to the ICU. The patients remain either in the emergency department, creating an overcrowded emergency department, or in post-op, causing overcrowding and delays in scheduled surgeries.

The hospital has just received $50 million in grant funding from a wealthy donor and is considering expanding the ICU; however, the CEO is not convinced that expanding the ICU department is the right hospital solution. The analysis is to include options that combine expanding the ICU department by using remote ICU monitoring.

The ICU senior staff brought you in as a consultant to build a business case to support the decision to expand the ICU and use remote ICU monitoring. You will work with the ICU’s senior staff to make a business case and present it to the CEO and board of directors for final consideration. There will be great emphasis on data and analyses supporting your recommendation. Because of this, you need to use data derived from informed or objective sources or evidence-based data to build the recommendation. The CEO will want to know the sources, validity, and reliability of the evidence presented.

Excerpts of a Conversation with George Mallory: Senior Staff Representative

George: Hello, Raul; it is good to meet you. We look forward to working with you on this business case to expand the ICU. We have already completed some research on the ICU’s right size, and we will share that with you throughout your investigation.

Raul: Hi George, I appreciate you taking the time for this interview. This will help me research how much to expand the ICU; I am also considering using a remote ICU monitoring service to complement expanding the ICU.

George: Remote ICU monitoring services are a topic that will cause much consternation here at United General. Several staff members fear that a remote service will put them out of a job to touch lightly on that subject.

Raul: Has your group researched remote ICU monitoring services in the area?

George: We started to but realized it was so controversial that it was not an option. If you look into a remote service, please take the staff into account in the analysis.

Raul: What caused the controversy with the idea of remote ICU monitoring?

George: Physicians were reluctant to cede authority to a remote operation, and nurses were concerned about losing autonomy. A few nurses voiced concerns during a staff meeting because their colleagues complained of a poorly executed implementation.

Raul: Thank you, George; I will. Can you tell me who on your staff has the research on the remote ICU monitoring services?

George: That would be Frank. Frank looked at the services from the standpoint of patient and staff benefits and cost savings and how the services help the patient. We suggested that he speak to staff in hospitals that have implemented these services to get their reaction to the change, but he never went through with that because the staff was so set against it. It will be a hard sell to the staff.

Raul: Thank you for the heads up. Was there any other research completed about expanding the ICU that I could use?

George: I cannot think of anything else. You may want to check with other hospitals that use these services as part of your study.

Raul: Thank you, George; I have enough to start. I will check back with you if I need any help.

Excerpts of a Conversation with Frank Bellamy: Senior ICU Staff Member

Raul: Hi, Frank. My name is Raul, and I want to discuss your remote ICU monitoring research. I am working on a business case to expand the ICU and couple it with remote ICU monitoring

services.