The Mike O’Callaghan Military Medical Center at Nellis Air Force Base, Nev., has partnered with the U.S. Department of Veterans Affairs Tele-Intensive Care Unit staff to work collaboratively with the bedside team to allow continuous monitoring of the ICU patients’ vitals when medical center providers are out of the room assisting other critical patients.
The VA Tele-ICU center, located in the Veterans Integrated Services Network 23 (VISN 23) in Minneapolis, Minnesota, is now linked to the medical center ICU where patients’ bedside clinical data will be made available to ICU intensivists, nurses and medical technicians through non-recording cameras, video display, microphones and speakers.
“Nellis is the first Air Force base to have a Tele-ICU system,” said Capt. Genevieve Boldin, 99th Inpatient Squadron registered nurse. “It has taken years of hard work to finally get this program here. We were selected as the first base to house this program in our ICU due to the size, skills, services and willingness of our teams.”
Practitioners with the VA Tele-ICU use the camera to perform patient assessments, participate in interdisciplinary communication, provide bedside assistance and conduct patient rounds. (The cameras installed in the ICU rooms are dormant when not in use and do not record sound, video or still shots.) To contact the VA Tele-ICU nurses for assistance, patients and medical center staff must press the green “eLert” button located on the wall in the room.
“The Tele-ICU team can provide real-time advice regarding patient care with access to the patient’s electronic medical records, radiology imaging, labs, current vital signs and vital sign trends,” said Maj. (Dr.) Matthew Fain, 99th Medical Group critical care unit director, staff pulmonologist and intensivist. “This allows both ICU teams to make more informed decisions regarding patient care.”
The medical center currently has five rooms with the VA Tele-ICU system fully installed. Those rooms are given to patients needing the most care and attention. As the program progresses, the staff hopes to add more VA Tele-ICU systems throughout their ICU, said Boldin.
The Tele-ICU system has helped in the prevention of ventilator-associated pneumonia, catheter-related bloodstream infections and stress ulcers because it provides the patient two nurses and two doctors throughout their hospital stay. This aid in prevention reduces patient transfers, ICU lengths of stay and patient mortality rates, according to a study published by Dr. Craig M. Lilly, University of Massachusetts Memorial Medical Center.
Telemedicine continues to gain traction across the country as a force multiplier in the delivery of critical care. This program demonstrates the Air Force Medical Services’ Trusted Care System vision of improving patient safety, increasing quality of care and decreasing ICU cost.
“Through co-management, the partnership between the medical center ICU and VA Tele-ICU enhances exceptional care of our nation’s critically ill active-duty, retirees, veterans and eligible family members,” said Boldin.
The integration of VA Tele-ICU into the medical center ICU’s workflow takes time and effort from both parties. The practitioners in Minneapolis and the staff at the medical center will work close together through constant communication to minimize the bedside interruptions and support a smooth work flow and hospital stay, said Boldin.
“Our partnership with VISN 23 has been great,” said Boldin. “It’s a wonderful team of extremely helpful and understanding doctors and nurses. We’re all looking forward to working with and learning from each other throughout this program.”