Issue:
Managing through a critical care challenge

In recent years, the mainstream medical community has come to accept the importance of staffing critical care departments with physicians who specialize in intensive care.¹ According to Bruce Bradley, director of the Leapfrog Group, “We estimate that almost 54,000 lives in the U.S. could be saved if hospitals staffed non-rural ICUs with intensive care specialists.” ²

At the same time, however, researchers find an alarming scarcity of intensivists available to staff America’s ICUs, and they predict that the problem will increase dramatically in the coming decades. ³ According to the Leapfrog Group, only one in ten ICUs in the U.S. meets the standard it recommends for ICU physician staffing. “Intensivists currently provide one third of ICU care and, without increased supply, will provide a smaller proportion in the future.” ⁴

Without significant, well-coordinated efforts to address the demand for ICU-related services, the supply of critical care specialists, and the care delivery process itself, the disease burden placed on our healthcare system could become unmanageable.

Solution:
Expanding the capabilities of the intensivist

As perhaps the most politically viable among these options, clinical workflow automation can impact resource use at the point of care in real time and through retrospective techniques such as aggregate outcomes measurement. As early as 1980, clinical research demonstrated the potential of computer-based systems to assist in reducing ICU length of stay. ⁵

Nearly 25 years later, electronic ICUs—critical care environments fully supported with information tools for documentation, medical records, order entry, decision support and more—have become a part of some healthcare providers’ strategic plans. ⁶

Clearly, one of the keys to mitigating the repercussions of the lack of intensivist capacity is to use their time more efficiently and effectively:

• Improve data quality and presentation. To enhance decision support and patient assessment, give intensivists more up-to-date, comprehensive and usable information and data presentation. Draw from a wider range of sources for greater continuity of data, and offer graphical displays, summaries, alerts and other advanced capabilities that will assist critical care physicians with diagnostic and treatment choices.
  
  
• Extend intensivists’ productivity. With labor-saving systems to consolidate and manage information, fewer physicians and nurses can monitor and treat more patients. Manual charting costs clinicians valuable time spent searching for records, requesting information, entering data, and performing administrative tasks. And in the ICU, where the cost of complications is high, clinicians and their patients stand to benefit from every moment refocused on actual patient care.
  
  
• Move toward the ‘electronic ICU.’ In the one setting with the greatest potential impact on patient health and resource use, begin working toward an electronic ICU. These systems boost ICU workflow and help clinicians respond more quickly to medical events at any time and from any physical location. The electronic ICU automates and integrates documentation across emergency, perinatal, and all departmental systems as well as physiologic monitoring devices at the point of care.

CliniComp Essentris™ Critical Care advantage:
Clinical documentation and EMR systems specifically for the ICU

A history of critical care excellence. Two decades ago, CliniComp began its work focused specifically on the needs and challenges in critical care environments. Today, CliniComp serves the largest critical care install base worldwide. From our origins in intensive care—the most demanding clinical environment—we have extended our products to serve clinical departments across the hospital and provide a solid foundation for more advanced clinical processes.

Fast, integrated clinical documentation. With Essentris™, clinicians input, edit, and access patient chart data simply and quickly. Physicians and nurses gain integrated access to readings, orders, results, and other data from a limitless range of systems including physiological monitors, devices, ADT systems, lab results and thousands of hospital-based systems.

• Automated clinical alerts and calculations. Essentris transforms your processes with precise patient monitoring, timely clinical alerts and reminders, automated clinical calculations and tasks list generation, online reference capabilities, and plan of care tools.
  
  
• Remote, configurable data presentation and visualization. A highly configurable platform, Essentris offers: flow sheets that easily capture and present common patient data types; clinical notes that can be customized to adapt to your workflow; and, summary screens that present lists, tables and graphs according to the needs of your clinical specialty. And with remote access, physicians and nurses access Essentris on the floors, at bedside, from the office, from home or via mobile device.

Enterprise-wide medical record access. Essentris forms the basis for a longitudinal, enterprise-wide medical record system that manages and tracks medications, procedures, physiologic monitor readings, progress notes, and other charted information while supporting order entry, decision support, outcomes measurement, reporting, analysis and other key functions.

¹ Fact sheet: ICU Physician Staffing. The Leapfrog Group, 2000.

² JAMA Study shows aging baby boomers to cause treatment demand pinch in critical care units. Press release. American Thoracic Society, December 5, 2000.

³ Angus, D.; Kelley, M.; Schmitz, R; White, A.; Popovich, J. “Current and Projected Workforce Requirements for Care of the Critically Ill and Patients with Pulmonary Disease: Can We Meet the Requirements of an Aging Population?” JAMA, 2000: 284:2762-2770.

⁴ Angus, D.; Kelley, M.; Schmitz, R; White, A.; Popovich, J. “Current and Projected Workforce Requirements for Care of the Critically Ill and Patients with Pulmonary Disease: Can We Meet the Requirements of an Aging Population?” JAMA, 2000: 284:2762-2770.

⁵ Cited in Berenson, R. A. “Intensive Care Units (ICUs): Clinical Outcomes, Costs, and Decisionmaking.”
(Health Technology Case Study 28), prepared for the Office of Technology Assessment, U.S. Congress, OTA-HCS-28, Washington, DC, November 1984.

⁶ Richard Haugh. “Pressures converge in the ICU: Hospitals turn to IT and process changes to improve outcomes and satisfaction.” Hospitals & Health Networks, December 2003.

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