Better ICU Management Improves Outcomes and Costs

The Intensivist Group provides state-of-the-art management of intensive care units that dramatically reduces mortality and complications for patients and improves financial outcomes for hospitals. It also enhances compliance with established guidelines for ICU care such as those published by the Leapfrog Group.

Our intensivist-led model has proven successful in both in-hospital settings as well as through off-site management, where our critical care physicians use innovative technology to remotely monitor critically ill patients and direct their bedside care.

On-Site Management

We start by staffing hospital ICUs with a team of board-certified intensivists. In addition to caring for patients, our intensivists create and institutionalize evidence-based protocols and standardized order sets to cover a broad range of clinical issues.

To do so, we work closely with physicians and other members of the hospital staff, including representatives from nursing, pharmacy, discharge planning, nutrition support, pastoral care, and respiratory and physical therapy. We also collectively establish key measures of performance, such as days on mechanical ventilation and length of stay, and set targets with dates for achieving the goals.

The team, along with members of the medical staff, meets regularly to review the protocols’ effectiveness and other issues. In addition, the intensivists lead daily, multidisciplinary rounds.

This approach measurably increases doctor and patient satisfaction, significantly improves care and outcomes and drives cost savings. Results at ICUs managed by The Intensivist Group include:

• In the first six months at Mercy Fitzgerald Hospital, length of stay fell by a half-day, resulting in annualized savings of nearly $1 million.
• At Northwest Community Hospital, patients rated the overall ICU care at 94%.
• Medical staff at Northwest Community rated critical care as the highest quality service at the hospital and the second most important reason for referring patients there.
• Mercy Philadelphia Hospital’s mortality rate for critically ill patients has decreased from 11.7 percent to 7 percent, which means one additional life is saved for every 21 ICU admissions.
• Length of stay has shrunk from 3.74 days in 2003 to 3.02 days in 2007 at Mercy Philadelphia Hospital, creating 1,227 additional ICU bed days and saving the hospital $850,000 annually.
• Mercy Fitzgerald’s ICU relative mortality rate declined from 16.1 % to 11.9% in just six months.

ICU Consulting

With critically ill patients accounting for nearly 30 percent of their total costs, hospitals are eager to institute better ways to organize and manage their intensive care units. The Intensivist Group provides objective evaluations of critical care services. Our clients include community hospitals that are dissatisfied with their current intensivist-led programs as well as hospitals that want to assess the benefits, costs and issues of introducing an intensivist-led approach.

While we adapt our approach to fit the needs and circumstances of each hospital or health system, we provide on-site evaluation and information gathering along with analysis based on our deep expertise in critical care best practices. Our consulting engagements are led by physician experts who spend several days conducting structured interviews, reviewing charts and observing the delivery of care in the ICU or ICUs. In addition, we review all ICU protocols, order sets and physician contracts for intensivist services.

Based on the information provided, The Intensivist Group also assesses the available ICU performance data for both quality and results achieved. When possible, we benchmark the hospital’s outcomes against national data.  We present the analysis and key recommendations for restructuring critical care services, including financial models of how the proposed changes will affect costs and revenues, in a comprehensive written report.