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How does a clinical care nurse coordinator improve the quality of life for our clients at home for a 24-hour specialist nursing roster with critical care nurses? That’s what I’m going to answer today.

My name is Patrik Hutzel from intensivecareathome.com.

Today, I have a question that actually comes from a funding body who has asked us, “How does a clinical care nursing coordinator, 20 hours a week, improve the clinical nursing care for a 24/7 home care nursing client with traumatic brain injury, spinal cord injury, asthma, suprapubic catheter? Client’s GCS (Glasgow Coma Scale) is around 8 to 10, PEG tube (Percutaneous Endoscopic Gastrostomy) client, on Airvo oxygen, intermittent seizures and epilepsy, with episodes of low sodium, needs deep suctioning, chest percussions?” He’s got left hemiplegia and he’s got deranged LFT (Liver Function Test) so it’s quite a complex client for us.

We’ve advocated for a clinical care coordinator to make the program more sustainable, make the program safer. This client is a client that has been in and out of hospital for the last few years. We’ve worked there now since about August last year. We’ve minimized the hospital readmissions to a bare minimum. But with the clinical care nurse coordinator, we can probably bring it down to a bare minimum, if not excluded.

Let’s look at details in how a clinical care nursing coordinator, 20 hours a week, will help strengthen a 24-hour nursing roster at home for a critically ill patient with 24-hour critical care nurses at home. So, a clinical care nursing coordinator working 20 hours per week plays a crucial role in improving the quality, consistency and safety of care for a client with complex high acuity needs, like the clients I have described and here’s how.

Number one, clinical oversight and care planning develops and updates care plans that reflect the client’s dynamic needs, especially important given the client’s GCS of 8 to 10, regular seizures, PEG feeding, oxygen dependency, and I should say, deep suctioning requirements. The care coordinator we coordinated with specialists, neurologists, respiratory therapists, dieticians to ensure evidence-based multidisciplinary care. The clinical care coordinator also ensures care plans include early warning signs for deterioration, i.e., seizures, respiratory distress, low sodium, signs of liver failure, etc.

I should also say that for other clients of a similar nature, we have care coordinators, 12 to 20 hours a week, and it’s making a huge difference for the program. It is much more stable. Clients have a report of a better quality of life. The staff report a more staff satisfaction and it is easier to coordinate complex care programs.

Next, staff supervision and clinical training. The clinical care coordinator provides clinical leadership to the home nursing team ensuring they are competent in deep suctioning techniques and infection control, PEG feeding, Airvo and oxygen use, seizure management protocols and emergency response, delivers education and simulations tailored to the client’s complex needs, conducts regular competency checks and mentors staff.

Next, it helps with rostering quality and continuity of care. A care coordinator ensures that the right skill mix and experience is always present across the 24/7 roster. The care coordinator will also identify gaps in knowledge or performance and adjusts staff assignments or initiates training as needed. A care coordinator helps prevent burnout and turnover, which improves care consistency and staff morale.

Next, risk mitigation and incident management. Reviews and acts on incidents, i.e., seizures, desaturation events, aspiration, sodium drops, identifies trends and leads quality improvement initiatives to reduce preventable complications, and implements clinical escalation protocols and ensures nurses know when and how to act.

Next, number 5 is liaison and communication. Acts as a key liaison with a GP (general practitioner), allied health team, pharmacy and hospital specialists, ensures changes in medical orders, i.e., seizure medications, electrolyte correction are communicated and implemented promptly, keeps family carers informed which supports shared decision making and reduces stress.

Documentation and compliance, number 6. Reviews clinical notes to ensure accuracy, completeness, and compliance with standards and regulatory frameworks. Ensures that essential monitoring, fluid balance, seizure logs, O2 SATs (oxygen saturations), LFT trends are documented and reviewed and prepares for and supports audits or reviews, i.e. NDIS (National Disability Insurance Scheme), TAC (Transport Accident Commission) home care packages, insurance, etc., and with the overarching goal of improving the quality of life for the client, reducing hospital admissions, and maintaining staff satisfaction and staff retention, because home care is all about creating the right teams around the right client.

So, why 20 hours and why is it effective? Even at 20 hours a week, if well allocated, this role stabilizes care, prevents hospital admissions, reduces critical incidents, and supports nursing staff to deliver complex care with confidence, and it fills the gap between frontline nursing care and broader healthcare systems, acting as the clinical backbone of our service.

So, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. That means, we are providing a genuine alternative to long-term stay in intensive care for ventilation, tracheostomy, Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), ventilation without tracheostomy, tracheostomy without ventilation, Home TPN (Total Parenteral Nutrition), home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics. We’re also providing ventilation weaning at home. We’re also providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home. We’re also providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home as well as palliative care services at home. We also use cough assist machines for our clients for airway clearance.

We are also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to the emergency department.

That also means we’re in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services cost between $2,500 to $3,000 per day and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. But most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life at home is much improved surrounded by families.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We’re an NDIS (National Disability Insurance Scheme) approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), as well as the Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a provider, have also received funding through public hospitals, private health funds, as well as departments of health.

We are currently the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this level of accreditation since 2012. No other service provider has achieved this high level of accreditation in the community and has created more intellectual property for Intensive Care at Home nursing than we have. This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or if you’re stuck in an ICU, or if you’re going to hospital and ED (emergency department) all the time, and you realize that you don’t have the right level of support, I’ll give you another tangible and real-world example today, very similar to the one I gave you a minute ago.

One of our first clients when we first got started over 10 years ago, was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are dangerous and negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with the cabin crew instead of the pilot because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7 or even at high risk of dying if they don’t have a team of critical care nurses looking after them 24/7. This is actually evidence-based and it’s documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after a critical care patient on a ventilator with a tracheostomy. So, why would anyone in their right mind would do that in a home care environment in the community?

So, this client found out about us eventually and the ICU that he went back to all the time also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with the client, we sent him intensive care nurses, 24 hours a day. He never, ever went back into ICU ever again and we were proving our concept there very fast.

We can do the same for you if you’re not safe at home which includes the advocacy for funding that goes along with it. We have always successfully advocated for our clients. Otherwise, we would not be in business. The same is applicable for those stuck in an ICU, similar to our case study today, or going back to ED all the time, so what you’re looking for? Reach out to us, we’ll make it happen for you as well. We can take you through the right steps including NDIS or other funding bodies, and the advocacy that needs to go along with it.

Which is also why we are providing Level 2 and Level 3 NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches, one of our NDIS Support Coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS Support Coordinator or a case manager from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for nursing care for your participants, and you don’t know how to go about it and what evidence to provide, I encourage you to reach out to us as well. We will help you with the right level of funding and with the right level of advocacy. We’re also providing NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

If you are a critical care nurse and you’re looking for a career change, and you want to join a very progressive, dynamic, high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined. If you are looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, and in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I have a disclaimer, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are very vulnerable and very special, and that’s why we need regular staff. So, if you’re looking for agency work where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availabilities for shifts and if you’re really keen on building relationships with us and with our clients.

If you are an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well. We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients, or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is much more cost-effective than what you’re paying for in ICU and ED, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. or in the U.K. and you’re watching this and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care, click the like button, click the notification bell, share the video with your friends and families, and comment below what you think about this video or what you want to see next.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care.