Minneapolis VA Health Care System
The Tele-ICU is a support service, designed to provide electronic access to specialty-trained, board-certified critical care physicians working in close concert with experienced critical care nurses, in locations or during hours when this service cannot be adequately or practically provided locally.
Several factors have led to increased interest in the concept of remote electronic access to supplement on-site ICU coverage. There are not enough specialists to meet the demand. Intensivist coverage is not practical, affordable or in some cases even possible for smaller, rural community hospitals. Quality of care and patient safety concerns, residency work rules, nursing turnover and changing demographics have created additional challenges in managing an increasingly high risk patient population.
These challenges include increasing age, severity of illness and complexity of adult ICU patients. Nursing “burnout” and turnover inevitably leads to less experienced nurses in the ICU. Residency program work rules require fewer hours in the hospital for residents, leading to an increased number of patient “hand-offs” and less continuity of care by residents. This in turn demands a higher level of supervision by attending staff physicians. In the intensive care unit, the traditional model of call from home is often no longer adequate.
Key Components to Tele-ICU System
The Tele-ICU employs a telecommunications and software system designed to provide an added layer of clinical support to bedside clinicians in managing a high risk patient population. It is a population subject to sudden and unpredictable changes in census and acuity - and therefore workload. There are four key components to the Tele-ICU system.
Telecommunications equipment in the patient’s ICU room: a microphone, speaker, two-way high-resolution ceiling-mounted video camera and video screen permitting the patient to see and hear the remote ICU physician or nurse, and the Tele-ICU physician or nurse to see and hear the patient (or family member or bedside nurse) in real time. Nursing staff or others can obtain immediate contact with the Tele-ICU support center via high-speed dial telephone or via a “hot-button” on the wall of the patient’s room.
Tele-ICU software that tracks and monitors real-time physiological data at bedside, such as blood pressure and heart rate, and critical lab data and then generates algorithm-based critical alerts to the Tele-ICU nurses and physicians, allowing them to look deeper into the patient’s clinical condition in a pro-active manner, before a full blown critical event occurs.
Tele-ICU monitoring and support center remote (off-site) to the monitored ICUs. This center could theoretically be located anywhere. The work stations are equipped with a bank of monitoring screens and tools: patient census screen, vital sign and lab alerts, patient profiles designed to facilitate workflow by Intensivists, live two-way audio-video feed, electronic medical record (CPRS), digital imaging (PACS) and ICU Clinical Information Systems (CIS).
Clinical staff, the Intensivists and Critical Care Nurses.
One Veterans Drive,
Minneapolis, MN 55417
Hours of Operation