CT – Sept 2014(Please find the original article here in the ACCCN newsletter or find the PDF below)
ResMed-Flyer ANZICS10.2014 (Invitation to ANZICS breakfast session on the 10/10/2014 or find the PDF below)
Hi it’s Patrik Hutzel from www.INTENSIVECAREATHOME.COM.AU where we provide tailor made solutions for long-term ventilated Adults& Children with Tracheostomy by improving their Quality of life and where we also provide tailor made solutions to hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!
In last week’s blog I shared “6 things NOBODY HAS EVER TOLD YOU about long-term ventilation with Tracheostomy at home”
You can check out last week’s update by clicking on the link here.
In this week’s blog I want to share with you an article that was published in this month’s ACCCN(Australian College of Critical Care Nursing) newsletter
The title of the article is “Home Care for long-term intensive care patients”
The article in the ACCCN journal highlights once again how important home care as a genuine alternative is becoming in the context of Australian critical care
Home Care for long-term intensive care patients
BY PATRIK HUTZEL, Critical Care Nurse, Founder and Director
Intensive Care at Home Pty Ltd
Compared with many European countries, home care as a genuine alternative to an indefinite stay in intensive care seems to be somewhat too far outside of the current Australian intensive care paradigm for patients with chronic respiratory insufficiency requiring long-term mechanical ventilation.
That’s how Patrik Hutzel, founder and director of INTENSIVE CARE AT HOME Pty Ltd felt when he first came to Australia and started work as a critical care nurse in intensive care in Sydney 2005.
Having worked in intensive care in the United Kingdom prior to moving to Australia, he also spent two years in Munich pioneering one of the first intensive home care nursing services to be established in Germany.
The service opened its doors in 2001 so that long-term ventilated adults and children in Germany who were dependent on mechanical ventilation using an artificial airway (tracheal cannula) to the trachea could to be cared for in their own home.
Intensive home care as the next natural evolution
Home care for this group of intensive care patient seemed to be the next natural evolution of mainstream home care services already established in Germany. After these services had proven
to be of benefit to patients recovering from hospitalisation it only required a small shift in thinking to consider extending the service so that long-term ventilated patients who were otherwise stable could be instead looked after in their own home.1
It would improve the quality of life for these patients and ease demands made on family members, reduce the number and duration of beds in intensive care being blocked by long-term ventilated patients, and offer the potential to save money for healthcare managers.2,3
For more than 15 years the concept of looking after patients who require long-term ventilation at home is now established in Germany as an extension to hospital intensive care services and is accepted as the best choice for the on-going management of these patients.
“The goal is to offer a similar service to what is currently available in Germany by providing patients the opportunity to be managed in their own home and thereby improve the quality of life and/or quality of end of life despite the requirement for long-term ventilation.”
Long-term ventilated patients in intensive care are facing a massive dilemma and it hasn’t been addressed properly here in Australia
After having looked after many long-term ventilated patients here in Australia, Patrik realised that these patients had nowhere else to go other than to remain in intensive care. On the other hand Patrik knew what opportunities long-term ventilated patients and their families had in Germany.
The Australian health care system is very different compared to Germany as it relates to funding.4 However, the issues that long-term ventilated patients face in regards to poor quality of life and the problem for managers of limited health care resources remain the same.
In reflecting upon his experiences in Germany, Patrik decided to do something about the dilemma here in Australia and started his own nursing service INTENSIVE CARE AT HOME Pty Ltd.
His goal is to offer a similar service to what is currently available in Germany by providing patients the opportunity to be managed in their own home and thereby improve the quality of life and/or quality of end of life despite the requirement for long-term ventilation.
The limited competitiveness of the Australian health care system compared to the European health care system has nevertheless proved to be an obstacle in delaying such an important innovation. At present it might get delayed but certainly won’t be stopped due to the problems of an ageing population with multiple co-morbidities, increasing the demand for intensive care beds, and the health care consumer whose increased expectations of what should be provided need to be somehow managed by Governments faced with escalating healthcare costs.
Patrik is of the belief that the provision of home care even for high acuity patients such as those who require long-term ventilation is not a matter of if, it’s a matter of when it’s going to happen!
“Only critical care trained nurses who demonstrate they have the skills to care for these patients safely are employed who have the additional mindset and “can-do” attitude that is needed to facilitate a transfer home.”
Health service accreditation achieved as major milestone for Intensive Care at Home Pty Ltd
In order to make Patrik’s vision a reality INTENSIVE CARE AT HOME Pty Ltd has achieved full health service accreditation against the Australian national health care standards and has also been accredited against ISO 9001/2008 in meeting customer and statutory requirements.
The health service accreditation has been a major milestone in moving Intensive Care at Home PtyLtd towards reality and in achieving its goal.
The process for accreditation was fairly similar to accreditation that is required for Australian intensive care units. Instead of a hospital setting the standards, as well as policies and procedures are just being applied to a home health care setting.
It is however a fairly lengthy process. It was especially difficult for Patrik since he was required to start the process from scratch!
Intensive Care at Home Pty Ltd can provide services that are similar to those provided in intensive care in situations where long-term ventilated patients with a tracheostomy are either in situations where they are going through:
- A long term weaning process such as required for Guillan Barre Syndrome or other neuromuscular diseases
- A life-long ventilator dependency due to a cervical spinal code injury affecting respiratory function
- An end of life situation where they have remained on a ventilator in intensive care for an extended period of time
Intensive Care at Home Pty Ltd can provide a twenty four hour, seven day a week service for patients who are eligible to be managed in their own home while continuing to require long- term ventilation.
Only critical care trained nurses who demonstrate they have the skills to care for these patients safely are employed who have the additional mindset and “can-do” attitude that is needed to facilitate a transfer home.
You can learn about what it means to finally have the opportunity to go home by accessing Intensive Care at Home Pty Ltd website and reading about the real life story of Leon who was a ventilator dependent patient https://intensivecareathome.com/case-studies/ .
Evidence based practice is key to the success of Intensive Care at Home Pty Ltd
As far as evidence based practice is concerned the German society of respiratory physicians has published the “Mechanical Home Ventilation Guidelines” and Intensive Care at Home Pty
Ltd has published these guidelines on its website https://intensivecareathome.com/mechanical-home-ventilation-guidelines/
Intensive Care at Home Pty Ltd is of the opinion these guidelines, as well as accreditation against national Healthcare Standards https://intensivecareathome.com/Accreditationquality/ is a great starting point to do what has for many years been done successfully in Germany.
- World Health Organisation. Home care in Europe, the solid
facts 2008; Retrieved from www.euro.who.int/_data/assests/
pdf_file/0005/96467/E91884.pdf accessed 21st August 2014.
- Geiseler J, Karg O, Borger S, Becker K, Zimolong A. Invasive
home mechanical ventilation mainly focused on neuromuscular
disorders. GMS Health Technology Assessment. 2010;6:
Doc 08. doi 103205/hta000086.
- Markstrom A, Sundell K, Lysdahl M, Anderson G, Schedin
U, Klang B. Quality-of-life evaluation of patients with
neuromuscular and skeletal diseases treated with noninvasive
and invasive home mechanical ventilation. Chest.
- International Profiles of Health Care Systems 2012; Retrieved
Copyright of this article remains with the ACCCN Critical times newsletter
What are your thoughts?
Do you think that Intensive Care Units can offer what a home care environment can’t?
Leave your thoughts and comments on the blog here!
Please also note that INTENSIVE CARE AT HOME has been selected as a preferred provider for Queensland Health Services as part of the recent “Hospital in the Home” tender.
INTENSIVE CARE AT HOME will also be a sponsor in the upcoming International Tracheostomy Symposium (ITS) 2014 on the 8th October 2014 at the Melbourne Convention and Exhibition centre! Come and visit us at our exhibition space there!
Also check out the ANZICS 2014 Breakfast sessions on Friday the 10th October 2014 in Melbourne where I will be giving a presentation about the service. You can check it out here.
You can also contact me on 041 094 2230 if you want to know more about how we can help you, your Intensive Care Unit and your Patients and Families.
Thank you for tuning into this week’s blog.
This is Patrik Hutzel from www.intensivecareathome.com.au and I’ll see you again in another update next week.