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D5 Unit’s ‘care in place’ ready for winter

By Sarah Horn, Chief Nursing Officer

Winter is almost here, and one thing we learned last year is we didn’t have enough intermediate care unit beds. As part of this year’s Financial A3 strategy, we conducted an evidence appraisal on reducing unnecessary patient transfers between Medical Telemetry (formerly in 4South, now in D5) and IMCU.

Data showed these units have the highest number of patient transfers, along with similar patient populations. Over the last several months, RNs on the D5 Med Tele Unit have completed numerous competencies and trainings to safely care for patients requiring a higher level of care. Med Tele has developed clinical criteria for patients that admit or transfer to the unit, to ensure correct bed placement. Physician involvement is imperative, as you are the level of care decision-makers. We would like to extend a thank you to Dr. Urvi Mevar as our physician champion for this A3 strategy work.

Beginning in October, the first phase rolled out with nursing providing intermediate care to patients who were on D5 who declined or decompensated, thereby avoiding a transfer to IMCU. Data shows a cost of $800,000 (629 transfers in 2016) for transfers between Med Tele and IMCU; $600,000 (or 75 percent) was potentially avoidable. A reduction in these transfers not only reduces the average length of stay, it improves the patient’s experience and overall bed-flow of the organization, creating capacity to admit patients from the ED or community more efficiently. Phase two began in November with the Med Tele Unit accepting ICU patients who still required intermediate care.

In December, the unit began the final phase, accepting intermediate level of care patients directly from the ED.

Our commitment and priority is always for patient safety. We recognize there may be more questions from the care team as they continue to work through this learning curve. Please reach out to the unit leadership if you have any concerns. Our goal is to continuously improve while providing excellent patient care and outcomes.

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