Mercy Fitzgerald Delivers Important Gains
for Its Sickest Patients

Mercy Fitzgerald Hospital had a strong recommendation to bring in The Intensivist Group to manage its 18-bed medical intensive care unit (ICU.) Just six miles away at its sister facility, Mercy Philadelphia Hospital, The Intensivist Group had produced major improvements in ICU care and efficiency.

Mercy Fitzgerald hasn’t been disappointed: Under The Intensivist Group’s management, ICU patient outcomes improved, hospital length of stay has decreased by nearly two days and ICU length of stay has declined by more than one day, even as the number of patients treated in the ICU has grown by more than 20 percent.

As a result of the strong performance, Mercy Fitzgerald asked The Intensivist Group to manage its 12-bed surgical ICU as well.

“We are committed to achieving the highest quality care possible,” says Ruth Thomas, Mercy Fitzgerald's vice president of operations. “High quality does not have to equal high cost. With The Intensivist Group’s best-practices approach, we are substantially improving outcomes while also improving efficiency.”

Collaboration is Key

The Intensivist Group focused on building a multidisciplinary ICU team to deliver evidenced-based care. It instituted daily, intensivist-led rounds that included medical residents, ICU bedside nurses and pharmacists, and medical and pharmacy students, with input from respiratory therapy, case management and nutritional support.

From the start, The Intensivist Group had strong support and cooperation from a key constituency, Mercy Fitzgerald’s pulmonologists. The pulmonologists also practice at Mercy Philadelphia Hospital, where they had worked closely with The Intensivist Group to achieve substantially higher ICU performance.

“Very quickly, our physicians and clinicians saw first-hand how effective and collaborative The Intensivist Group is,” says Sharon Carney, MD, associate chief medical officer.

Best Practices Pay off

With Mercy Fitzgerald’s physicians, The Intensivist Group’s board-certified critical care physicians developed and implemented literature-based protocols and order sets. Then, they put in place improvement goals and a data-driven process for measuring key metrics,  such as length of stay.

The intensivists, emergency department and Dr. Carney, for example, created a sepsis order set to ensure timely resuscitation and compliance with the sepsis bundle. The ICU team also established an extubation protocol so all appropriate patients receive daily interruption of sedation and spontaneous breathing trials. As a result, average duration on mechanical ventilation fell 20 percent in one year.

Mercy Fitzgerald’s physicians showed their support of The Intensivist Group’s approach and the resulting critical care improvements in the hospital’s annual physician survey. The medical staff named intensive care as the second-highest rated service at the hospital.