Hi it’s Patrik Hutzel from INTENSIVE CARE AT HOME where we provide tailor made solutions for long-term ventilated Adults& Children with Tracheostomies 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 the last blog I shared
You can check out last week’s blog here!
In this week’s blog I want to share another hot topic with you when it comes to long-term ventilated adults& children with tracheostomies in Intensive Care and the topic this week is
Intensive Care at Home: An Opportunity or Threat?
A new report reveals that INTENSIVE CARE AT HOME is an opportunity and not a threat!
Whilst most Intensive Care Units are still living in the dark ages and are at least 20 years behind, we are already providing and offering a service that people want, that saves about 50% of the cost of an Intensive Care bed, frees up expensive, precious and “in-demand” Intensive Care beds and most importantly improves the quality of life for long-term Intensive Care Patients and their families!
And we haven’t even re-invented the wheel, we are only providing what’s been proven and evidence based best practice in Germany since the last 1990’s when INTENSIVE CARE AT HOME services started to serve a growing need with real world results and improved outcomes for Patients, families, for health funding agencies and for Intensive Care Units!
We are just offering and providing what’s already successfully been done in other countries and we provide it in a proven framework, with a third party accredited system and we provide it according to best practice Home Mechanical Ventilation guidelines.
Here is the report from last year
INTENSIVE CARE AT HOME: An Opportunity or Threat?
Seyed Sajad Razavi,1 Mohammad Fathi,1 and Mohammadreza Hajiesmaeili1,* 1 Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran *Corresponding author: Mohammadreza Hajiesmaeili, Loghman Hakim Medical Center, Kamali St., South Kargar Ave., Tehran, Iran. Tel: +98-2151025343, Fax: +98-2155424040, E-mail: [email protected] Received 2015 September 2; Revised 2015 November 27; Accepted 2016 January 4. Keywords: Intensive Care at Home, Critical Care at Home, Intensive Care Services, Critical Care Services Copyright © 2016, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM).
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
Although efficient hospital and intensive care unit (ICU) throughput depends upon the expeditious admission and discharge of ICU patients (1), health care systems are facing ethical challenges of caring for complex patients that are known as multimorbidity (2-8). A vast majority of patients need ICU admission; furthermore, when hospital occupancy is near its full capacity, prompt discharge of ICU patients to ward beds may not be feasible.
According to the national coalition of health care, the cost of health care in 2009 was approximately 2.5 trillion USD equal to 17.6% of the gross domestic product of the United States. The cost of caring for patients at ICUs in the United States has been estimated as 15% to 25% of all US hospital costs and from 1% to 2% of the gross national product. By 2019, these costs are expected to increase to 6% of the gross national product; an incredible 38% of the total US health-care costs (9). The annual cost of ICU hospitalization due to prolonged hospital length of stay is 33 billion USD (10).
There are patients who are no longer in the acute phase of their illness, but are not fully ready for ICU discharge. Besides, patients who are at end staged of their lives may benefit from discharging to home and continuing intensive care services at home (13). The resultant delay in ICU discharge not only artificially increase ICU occupancy rates, LOS, and costs for the patient (14, 15), and healthcare system but may also impede the admission of new ICU patients, potentially increases the risk of acquiring nosocomial infections, and would postpone the initiation of rehabilitative treatments (10, 16). This is that while professional society guidelines for ICU discharge has been written more than a decade ago but does not specifically address issues concerning ICU-tohome discharges (1, 11).
In this regards, previous studies have shown that many patients experience an extended length of stay (LOS) (10) with up to 30% of LOS being deemed unnecessary (12). Continuing intensive care services at home has several advantages, including an environment with reduced noise and night-time light favoring the return to more physiological circadian rhythms and better sleep, open visiting hours to allow unrestricted visits by relatives and friends, easier access to personal belongings, such as books, computers, tablets, TV, music players, and so on.
The management of these individuals generally involves more than only expertise in mechanical ventilation, but rather an integrated approach with harmonized procedures conducted by a multidisciplinary team (11). Besides, continuing intensive care services at home should also represent a cost-effective alternative to the ICU for the management of patients’ in need. It is important to note that policies encouraging early discharge. Besides, care services at home would require extensive assessment of both functional capacity of the patients and the skills and coping abilities of the care givers (17). This shift in care which would lead to reduction in length of hospital stay (18-21), providing a comprehensive precise and case-individual strategy, particularly for patients with several care needs.
This strategy could clearly predict the final destination where patient would receive care in, determine the care-givers and the treatment team (22, 23). Thus rehabilitation process would be expedited and decision making by treatment team would be facilitated. In addition it would help private health care agencies to plan properly and to provide suitable equipment, staff, etc (10, 19). The care previously provided by the hospital is now being provided by support agencies and/or, more importantly, by family members of the patient. Ultimately, we suggest that intensive care services at home for patients, family members and health care staffs is rather an opportunity than a threat; extensive original and systematic reviews in this scope is necessary.
Footnote Authors’ Contribution:Seyed Sajad Razavi, Mohammad Fathi, and Mohammadreza Hajiesmaeili made sub- Razavi SS et al. 2 Anesth Pain Med. 2016;6(2):e32902 stantial contributions to the conception and design of the study, were involved in drafting of the manuscript and revising for important intellectual content, approved the final version to be published, and agreed to be accountable for all aspects of the work.
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What do you think? Do you think INTENSIVE CARE AT HOME is an opportunity or a threat? Leave your comments on the blog.
If you want to find out how we can help you to get your loved one out of Intensive Care or Long-term acute care(also nursing home) or if you find that you have insufficient support for your loved one at home on a ventilator or if you have any questions please send me an email to [email protected] or call on one of the numbers below.
USA/Canada +1 415-915-0090
Australia/New Zealand +61 41 094 2230
UK/Ireland +44 118 324 3018
Also, check out our careers section here
We are also a NDIS, TAC(Victoria) and DVA(Department of Veteran affairs) approved community service provider in Australia.
Thank you for tuning into this week’s blog.
This is Patrik Hutzel from INTENSIVE CARE AT HOME and I see you again next week in another update!