Mercy Philadelphia Hospital Delivers Higher-Quality Critical Care at Lower Cost

Eager to find innovative ways to improve care and manage costs, Mercy Philadelphia Hospital in 2002 became an early leader among community hospitals in embracing the intensivist model for treating critically ill patients. Although its first try at bringing in an outside group of intensivists produced mixed results, the 266-bed, inner-city hospital persisted. It began making remarkable gains after turning to The Intensivist Group in 2004 to manage its 20-bed intensive care unit (ICU) including reducing mortality rates for critically ill patients by 40 percent while saving the hospital $850,000 or more annually.

Rather than simply rely on critical care physicians doing daily rounds, The Intensivist Group implemented a systematic program for managing Mercy Philadelphia Hospital’s ICU based on standardized best practices. It began by meeting with Mercy Philadelphia Hospital’s medical staff to begin building a collaborative relationship. To implement its comprehensive approach to care, The Intensivist Group’s board-certified intensivists also formed a team with representatives from nursing, pharmacy, discharge planning, pastoral care and therapy. 

Putting Patients First

The intensivists worked with the team to develop and implement evidence-based ICU protocols and standardized order sets that detailed such issues as sedation guidelines and how to wean a patient from a ventilator. The team also agreed on a process for measuring key performance metrics, such as length of stay and ventilator days, and set milestones with timelines.

The intensivist–led team, along with members of the medical staff, continues to meet weekly to review the protocols’ effectiveness and other issues. In addition, the intensivists lead daily, multidisciplinary rounds, part of the 24 hours of care they provide, including eight hours on-call each night.

"The Intensivist Group has transformed our ICU by implementing state-of-the-art critical care medicine that keeps patients at its very center. The protocols, the inclusive multidisciplinary approach and the emphasis on collaborating with our primary care doctors, hospitalists and specialists are all designed to deliver the best possible care and outcomes,” says Kathy Conallen, Mercy Philadelphia Hospital’s chief executive officer. “The Intensivist Group also has demonstrated that great medicine can be efficient and cost-effective.’

Improving Outcomes and Efficiency

On all key measures, The Intensivist Group has delivered major improvements. In one dramatic gain, the hospital mortality rate for critically ill patients has fallen from 11.7 percent to 7 percent. The mortality decrease means that for every 21 ICU admissions, one additional life is saved.

The Intensivist Group also has lowered the average number of ventilator days and average length of stay (LOS). The average days patients are on mechanical ventilation have dropped from more than 5 in 2003 to 3.13 in 2006, not only saving money for the hospital but also leading to shorter ICU stays and fewer complications such as ventilator-associated pneumonia (VAP.) LOS has declined from 3.74 days in 2003 to 3.02 days in 2007, creating 1,227 additional ICU bed days and saving Mercy Philadelphia Hospital $850,000 in 2006 alone.