Saving Lives Via Video At Sutter Health's eICU

Sepsis is a life-threatening bacterial infection in the bloodstream that kills thousands of people worldwide each year. The condition can be treated effectively with antibiotics, but only if it’s detected early enough.

Sepsis has been much less of a problem at Sutter Health since the network of not-for-profit hospitals and physician organizations implemented a set of standard sepsis screening and treatment processes throughout its 26 facilities in Northern California in early 2006. Sacramento-based Sutter Health’s sepsis program was made possible by a $25 million electronic intensive care unit (eICU) system that it finished rolling out last December. The setup includes video camera feeds from each ICU patient room and a system that sends patients’ vital signs to eICU computer screens that are monitored by doctors and nurses. Among 23,000 patients screened so far, the system has helped Sutter Health’s ICU nurses and physicians prevent an estimated 425 sepsis-related deaths, says Teresa Rincon, eICU nurse director for Sutter Health’s Sacramento/Sierra region.

> The eICU sepsis program has had other measurable benefits as well. “If we can treat sepsis and reduce septic shock, we can decrease a patient’s stay in the ICU by an average of four days,” says Grace Bourke, a clinical project manager at Sutter Health. Early prevention and treatment have saved about $2.6 million in treatment costs, according to Bourke.

Debbie Sleigh

Debbie Sleigh The sepsis program is a prime example of how the eICU system has helped Sutter Health dramatically improve its quality of care over the past few years. The project was spurred by a 2001 visit by former Sutter Health CEO Van Johnson to Sentara Healthcare in Norfolk, Va. Johnson was impressed by Sentara’s use of an eICU system, and he thought a similar system would be beneficial at Sutter Health, says John Mesic, chief medical officer for Sutter Health’s Sacramento/Sierra region and the clinical sponsor for the eICU effort.

> The initial rollout of the system, which is powered by software from Baltimore-based Visicu, began in Sutter’s Sacramento facilities in July 2002 and was completed in January 2003.

Several factors contributed to that relatively rapid implementation. (Sutter deployed the system to its two-dozen other California facilities over time, completing the effort late last year.) Rigorous efforts by Sutter Health’s IT project and facilities groups enabled the company to gain approvals for the project from the state’s chief regulatory authority within a matter of weeks rather than the standard eight to 12 months, says Mesic. “It could have taken three or four times as long if we didn’t have that intense effort from our IT and facilities people,” he says.

> Mesic’s staunch support of the eICU project was a huge help in moving it forward, says Debbie Sleigh, vice president of information services and the project leader. “Without John as our spark plug, it would not have gone as well and as quickly as it has,” says Sleigh. “From credentialing to adoption, John has [stood] behind this,” she says, noting his particularly crucial role in gaining buy-in from the medical staff.

Cultural Change

Given the cultural changes that an eICU project entails, Mesic’s sponsorship was critical. For example, the use of video cameras in patients’ rooms and the sharing of clinical data among eICU nurses, physicians and specialists “creates more transparency” than health care practitioners are used to, says Mesic. And standardizing departments on a set of proc­esses is as difficult in health care as it is in any other industry. So the clinical processes required by initiatives like the sepsis program didn’t come naturally to some of the medical staffers, he says.

> Moreover, an eICU system requires physicians, nurses and specialists to give up the tight personal control that they’re accustomed to exercising and work more like a team, jointly supporting one another’s patients.

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