Now, let’s shift to how you can bring ventilated and tracheostomy patients at home, or explore home nursing as an extension of ICU level care. We just covered powerful ICU advocacy consulting and ICU strategy for families in intensive care. Now, if your loved one is on ventilation and long-term ICU stay is looming, that includes often ventilation and tracheostomy, but also it could be LVAD (Left Ventricular Assist Device), RVAD (Right Ventricular Assist Device), long-term inotropes, such as milrinone, dobutamine, there is no alternative  by transitioning to home with Intensive Care at Home nursing support. That’s obviously where Intensive Care at Home is coming in.

Because with Intensive Care at Home, we are offering high intensity nursing, ventilator and tracheostomy care, non-invasive ventilation, Home TPN (Total Parenteral Nutrition), home IV potassium, home IV magnesium infusions, as well as central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line, and port management at home. It is a genuine and legitimate alternative to a long-term stay in intensive care. It’s not just theoretical, it’s not just a fancy name. It’s built on 24-hour ICU nursing support, clinical oversight, collaboration with hospitals, and a focus on quality of life. Also, a focus on saving costs for intensive care units. As a matter of fact, saving significant costs for intensive care units because we are cutting the cost of an intensive care bed by around 50%.

Let’s do the maths quickly. An intensive care bed costs around $5,000 to $6,000 per bed day. Intensive Care at Home costs around 50% of that. Think about that. That saves the healthcare system half of the cost, and it frees up the most sought-after bed in a hospital, which is the ICU bed. Once again, it’s clearly a win-win situation, and life only ever works if it’s a win-win situation. How do we make that happen? How do we get patients from an intensive care unit to a home care environment? Well, I’m glad you’ve asked.

First of all, we are making an initial assessment whether it’s feasible, whether it’s possible, clinically, of course. Then, we look at discharge planning. What needs to happen to get your loved one home? What equipment needs to be put in place? How many staff are needed for a 24-hour roster? I can tell you, we approximately need 8 to 12 staff, depends a little bit on location. We set up the equipment, we start hiring a team for a particular client. We look at obviously emergency protocols, care plans, work with OTs (occupational therapists), work with physiotherapists, work with speech therapists, work with doctors, nurses.

Just recently we’ve transitioned a patient from an ICU to home on BIPAP with motor neurone disease, BIPAP (Bi-level Positive Airway Pressure), PEG (Percutaneous Endoscopic Gastrostomy) tube, it’s all possible. We’ve transitioned many clients home, from ICU adult and paediatric ICU, to a home care setting with CCRNs and ICU nurses in the community.

We’re also now using our own ICU consultant to help with that transition. The good news is, more and more ICU units are coming to the party, for lack of a better term, and understand that this is not, Intensive Care at Home is not a fancy name, it’s not a marketing gimmick. It is a real thing.

Generally speaking, who’s a candidate? Patient needs to be medically stable, stable ventilator settings, ideally no inotropes, even though we could run low dose inotropes at home as well. There needs to be a manageable complexity. For example, if, God forbid, someone goes into ICU with multi-trauma after a motor vehicle accident or whatever, that is not an Intensive Care at Home environment. Intensive Care at Home environment is usually if someone’s been in ICU for many weeks or many months, they’re either ventilator dependent, they have a tracheostomy or they’re tracheostomy dependent without ventilation. They might be on TPN, they might be on long-term dialysis , which are the contraindications really.

What are the contraindications for Intensive Care at Home? It’s mainly hemodynamic instability and vasopressor or inotrope  dependency, especially if they are high levels or if someone is awaiting surgery.

Also, how do we evaluate risk versus benefits, let’s just take this patient that we took home recently from ICU. What were the risks to keep her in ICU? Well, the biggest risk was infection risk. It is so much more likely that a patient in ICU is ending up with another infection because they are not in a clean environment. They are in a “dirty” environment, with other infectious patients in the ICU. That’s a risk and it’s probably the biggest risk.

But another big risk is ICU delirium, ICU psychosis, patients not having any quality of life in ICU, families not having any quality of life in ICU. We are talking about a holistic care model here. Intensive Care at Home is a holistic, all-inclusive care model. We are not only looking at a patient’s diagnosis, we are also looking at their social environment. What do they need to go home? Has the family benefiting from going home? How is the ICU benefiting from going home? By freeing up the ICU bed and cutting the cost by 50%.

Another question that we always get is, “Is Intensive Care at Home available in my area?” With Intensive Care at Home, right now we’re operating all around Australia, in all major capital cities, as well as in all regional and rural areas. Location has never been an issue for us, and here is why. It really depends on, can we find staff? So far, we’ve always been able to find staff. Sometimes they can be, even in remote location, fly in, fly out arrangements, drive in, drive out arrangements, depending on the location. But location has never been an issue for us.

But location is an issue for patients and families, especially if, let’s just say they’re somewhere in country Victoria, country New South Wales, country Queensland, and they’re stuck in an ICU in Brisbane, in Sydney, in Melbourne, and they’re hours and hours away from where they usually live and their families are hours and hours away from where they usually live. Location has not been an issue.

Now, next question. Who’s funding all of this? Who’s paying for it? Well, before I go into this, first of all, let’s think about the mechanics of this before we go, who’s paying for it? Like I said, the ICU bed costs $5,000 to $6,000 per bed day. Intensive Care at Home is 50% of that cost. Do you think that someone would have an interest in slashing the cost of an ICU bed by 50%? It’s a clear hell yes. It’s not even a here or there. It’s a clear hell yes.

If you buy apples at the grocery shop for $10 a kilo and someone is selling you the same apples for half of the price for $5 a kilo, the same quality, the same apples, would you say yes? Of course, you would say yes. On top of that, the apples are being delivered to your home for half of the cost, because that’s basically what we are doing here at Intensive Care at Home. We’re delivering the intensive care into your home for half of the cost. Of course, there’s appetite and interest for someone to pay for this, clearly.

Who’s paying for it? Some of our clients are NDIS funded, the National Disability Insurance Scheme. Some of them are TAC funded, Transport and Accident Commission. Some of them are DVA funded, Department of Veteran Affairs. We’ve had some private health insurance funding, some department of health funding. But your biggest concern should not be who’s going to pay for it? Someone will. Because if that wasn’t the case, we wouldn’t exist. Our clients wouldn’t exist. Be less concerned about the mechanics and just start putting the mechanics into place, and we can help you with that. We will be the facilitator. I’ll give you another hint here.

When we first started out in 2012, I realized hospitals weren’t biting, they weren’t interested. Departments of health weren’t biting, they weren’t interested. But I tell you who was interested, you were interested. You watching this, families in intensive care, and that made all the difference. You as a family have way more power than you think you do, way more power. Believe me, trust me on that one. I can tell you that when we had clients pass away over the years with Intensive Care at Home, it was often due to lack of funding, but it was also due to lack of family advocacy. Families were intimidated by the authorities.

Well, what have I been saying here for over a decade on this channel, do not be intimidated by anyone because the minute you are, you’ll pay a heavy price. The clinical condition for our clients is fairly similar. They need ventilator. They often need a tracheostomy or the other way around, need a tracheostomy, sometimes they don’t need ventilation, sometimes they need ventilation, don’t need a tracheostomy. But the bottom line is this, all of them need 24/7 critical care nurses at home. That is actually, by the way, evidence-based. You can look up on our website, the Mechanical Home Ventilation Guidelines , which is evidence-based.

The Mechanical Home Ventilation Guidelines, which are evidence-based are a result of over 25 years of Intensive Care at Home nursing in Germany, and also a result of Intensive Care at Home nursing in Australia since 2012. What we do is actually evidence-based. We are also third party accredited for Intensive Care at Home nursing. No other provider in Australia has achieved a higher level of accreditation than we have, has policies and procedures for Intensive Care at Home, has built all the intellectual property around that, and that enables us to employ hundreds of years of critical care nursing experience combined in the community. No other provider brings a higher skill level into the community than we do.

I want to come back to, again, this client that we took home recently, just in the last two weeks really. She was in ICU for four months. A young lady, desperate to leave ICU to go home with her kids, 3 and 4-year-old children, with a husband, and we’ve managed to achieve that now. ICU was also desperate to free up their bed, by the way. It was a private ICU and they were losing money. I worked in ICU long enough to understand how private ICUs work.

There’s nothing that can’t be done if your loved one is stuck in ICU. There’s nothing that can’t be improved. A lot of it can be improved.

Now, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care for clients without ventilation
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning at home

We’re 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 an emergency department.

That also means, we’re also 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 costs between $2,500 to $3,000 per bed day, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. 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 is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

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 work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a service provider, have also received funding through public hospitals, private health funds, as well as Departments of Health.

We are having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia has created more intellectual property when it comes to 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 you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012, 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 not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a 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 dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is 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 your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing 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 need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, and high performing team of critical care nurses in the community, we’re employing hundreds of years of critical care nursing experience combined. You can join this high performing team if you are a critical care nurse.

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, 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 do have a disclaimer though, 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 so vulnerable and so special. 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 you’re really keen on building solid relationships with us and with our clients.

If you’re 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 so 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, or for 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. and 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 this video with your friends and families, and comment below what you want to see next or what questions and insights you have from this video.

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 for now.