Electronic ICU center will mean constant
attention
By David Steinkraus
MILWAUKEE - Later this summer,
intensive-care patients in Kenosha and Burlington won't be alone
even though no one is in their hospital rooms.
The machines
connected to them will feed information to an electronic monitoring
center on the south side of Milwaukee where special nurses and
doctors will look for signs of impending trouble, and will be
available to alert and consult with their hospital counterparts. The
system is the first of its kind in Wisconsin.
During a
demonstration of their new eICU center on Thursday for reporters,
Aurora Health Care officials said the system will improve the
quality of care while reducing cost.
"This is the most
expensive part of health care, intensive care units, so anything we
can do in the ICU to reduce health care costs will have a dramatic
impact on overall health care costs in eastern Wisconsin," said Dr.
Nick Turkal, Aurora's senior clinical vice president. |
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An independent study done for Norfolk General Hospital
in Virginia found that an eICU reduced deaths by 25 percent and
patients' length of stay by 17 percent, while the hospital saved
about $3 million.
"The bedside ICU nurse is always busy,"
said David Rein, a physician in private practice who specializes in
treating people in intensive care and who helps staff the Aurora
eICU. But in the ICU monitoring center, there are always specially
trained nurses watching the banks of computer screens, and computers
are programmed to warn nurses if a patient's vital signs
change.
"There's a good body of research out there that shows
there are vital sign changes preceding medical emergencies -
arrests, sudden death, that kind of thing. And these monitors pick
those up," Rein said. Not only do they pick up changes, but the
computers are programmed to take a patient's illness into
account.
The monitoring staff has instant access by computer
to a patient's medical records, to a history of the measurements
taken by the machines in the hospital room, to x-rays and to the
care plan prepared by the patient's primary physician. Should they
need to, the eICU specialists can turn on a camera in a patient's
room and talk to the nurse or physician there.
The purpose of
the center, aside from continuous monitoring, is to consult with
doctors and nurses, to provide specialized advice, Rein said. And,
in the time that he doesn't spend focused on one particular problem
with one particular patient, Rein said, he spends moving from
patient to patient, doing a sort of electronic rounds to check
everyone's condition.
"One of our goals is to survey and find
the things that lead to arrests and supercritical situations," he
said, adding: when those problems are intercepted, they don't become
major
problems.
As good as the cameras and other
equipment is, Rein said, it doesn't replace being at the bedside.
"We do get some good information from nurses in physical exam, from
watching them, but it's as good as doing it yourself. You can't
smell the patient because smell is something that we use. You can't
actually touch and feel how actually warm or cold or clammy a
patient is."
Use of the monitoring center will also mean that
people can be kept under intensive care without leaving their
community hospitals, Aurora officials said. The system will be
hooked into Aurora's Kenosha hospital on Feb. 8, and in July it will
be connected to Memorial Hospital of Burlington. By next year it
will be expanded to monitor about 250 intensive care beds at Aurora
hospitals throughout eastern Wisconsin, Turkal said.
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