Phoenix-based Banner Health is in the midst of rolling out a huge telemedicine program to every critical care hospital in its seven-state hospital system. This so-called eICU technology allows a team of off-site critical care nurses and physicians to remotely monitor ICU patients 24/7 as a backup to existing bedside caregivers.
One of the latest hospitals in Banner's system to receive this technology is Ogallala Community Hospital in Nebraska, which is the only rural facility in western Nebraska with this capability.
According to Daphne Wyatt, RN, Ogallala's interim chief nursing officer, the system offers a safety net for both patients and staff.
"Our staff here takes care of them, but they have that extra set of eyes," Wyatt said in an interview.
Here's how it works: Each ICU is equipped with a high-resolution, full-motion, two-way video camera with audio hookup. From the Clinical Operations Room (COR) on the Banner Desert Medical Center campus in Mesa, Arizona, specialists can assist the bedside caregivers to detect even the smallest changes in a patient's condition. Additional support and tele-monitoring at Ogallala and other Banner Health rural facilities takes place in Greeley, Colorado at Banner Health's North Colorado Medical Center.
According to John Hensing, MD, EVP and chief medical officer of Banner Health, the program uses an ongoing computer-based monitoring system that follows vital signs, respiratory rates, lab results, and other information, as well as nurses' notes and medical records to recognize minute changes in a patient's condition. When specialists detect a problem or concern, they can talk live to the caregiver at the beside and access the patient via voice, video, and data.
"It's trying to use the information system to recognize deterioration in patients' medical status before the bedside caregivers even know about it," Hensing said in an interview.
The system has paid off in terms of patient safety, Hensing said. The health system has seen double-digit reductions in overall hospital mortality, overall critical care mortality, overall length of stay in the ICU, and overall reductions in length of stay for ICU patients' entire hospital stay.
"We have reductions somewhere between 15 and 20% in all of those categories," Hensing said.
So far, Ogallala is one of only a few of Banner's rural facilities using eICU technology, but by this time next year, Hensing says the system will be rolled out to all other facilities with critical care beds. The implementation has gone smoothly so far, with enormous support from the hospital staff, patients, and their families.
According to Wyatt, the nurses at Ogallala have been enthusiastic. At first, physicians were a little leery of the idea of another doctor telling them what to do, but for the most part they're on board now, too.
"It's no different than calling up one of your doctor buddies," for advice, she said. Moreover, the system helps the hospital get by with stretched-thin physicians. Wyatt adds that since the hospital is close to a lake and an interstate highway, "we can get some really bad traumas." With thousands of people coming into the ED on the weekends and only one physician, the program is literally a life-saver.
The key to the successful rollout, Hensing says, is full dedication to the end result. All of their hospitals needed to be onboard in order for Banner Health to implement it over a period of several years, he said.
"This is a long process…the key to making it work is appropriate accountable leadership to make sure that the model is applied everywhere uniformly," he said. "This was patient safety issue; we were going to put it everywhere we operated, all of our beds, and making that happen with the appropriate steadfast leadership was crucial to our success."
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Alexandra Wilson Pecci is an editor for HealthLeaders.
