Hospital purchasing cooperative VHA started its Transformation of the ICU (TICU) program nearly two years ago with an eye toward improving clinical and financial outcomes and patient satisfaction in intensive care units.
Eric Dobkin, M.D., director of the surgical ICU at program participant Hartford (Conn.) Hospital, says critically ill patients and their families appreciate being kept informed.
ICU surgeons now receive a daily care plan for each patient during rounds to "make sure that the patient, family, primary surgeon and other surgical team members are on the same page," Dobkin says.
"It's placed in the door of the patient's room so everybody can see it. That tool has been profoundly effective in improving communication."
The teaching hospital follows an intensivist-led model of multidisciplinary care to include nurses, social workers and other clinical staff.
Additionally, Dobkin says, "We have started to invite patients' family members to make rounds with us."
VHA encourages participating hospitals to set up toll-free, password-protected voice-mail numbers for the family of each patient to listen to twice-daily updates from nurses. "It has been well received by patients with families out of town," Dobkin says.
Presbyterian Intercommunity Hospital in Whittier, Calif., a TICU participant, has seen its patient satisfaction scores on ICU noise levels improve by 17% since last year. Its overall ICU satisfaction scores have gone up 4% year-on-year, according to Mukesh Shah, M.D., medical director for critical care services. "We want to take away that element of fear," Shah says.
Other patient-friendly changes include longer visiting hours and increased availability of physicians.
"The biggest frustration for a family is not having a doctor available to talk when you need to talk," Shah says.