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 talked about
You can check out last week’s blog by clicking on the link here.
In today’s blog I want to focus again on the quality aspect when it comes to long-term ventilation and tracheostomy in a home care environment in order to provide a genuine alternative to a long-term stay in intensive care!
The 10 quality features to look for when it comes to home ventilation and tracheostomy!
When it comes to ventilation and tracheostomy in somebody’s home as a genuine alternative to a long-term stay in intensive care (ICU) you can’t budge on quality and you need to know what you’re getting yourself into before you can make an informed decision when getting your loved one home safely on life support…
We have many families in intensive care contact us and they think that they can just take their loved one home from ICU or PICU. They think they can do it themselves only to find that it’s too hard and too difficult and they literally crash and burn and their loved one is going back to ICU, making matters even worse for everyone.
Taking your loved one home on a ventilator with tracheostomy from ICU/PICU is also often against medical advice and I have more on that later.
Other issues we are finding is that long-term ventilated and tracheostomised Patients end up in LTAC or long-term acute care or even worse in nursing homes.
Those options are often the equivalent to a death sentence because the mortality rates in long-term acute care and/or in nursing homes are very high because they simply lack the skills, experience and know how in order to look after critically ill Patients that are life support dependent.
Therefore in order to enable you to do your research and chose the right service provider when it comes to your loved one being on the verge of wanting to leave intensive care (ICU/PICU) you will need to equip yourself with the right knowledge and with the right team around your loved one transitioning home on ventilation with tracheostomy from ICU or PICU.
Without further ado, let’s look at
The 10 quality features to look for when it comes to home ventilation and tracheostomy!
1. Look for an organisation that has experience in setting up INTENSIVE CARE AT HOME and has a proven track record taking Patients home from intensive care (ICU/PICU) safely!
Very few organisations (if any) can take ventilated adults and children with tracheostomies home from ICU or PICU. It takes specialised skills, experience, know-how, a “can-do” attitude and a level of sensitivity that most people and most organisations don’t have. Intensive care (ICU/PICU) is a highly specialised and very sensitive area and so is intensive care at home. For decades and since the “invention” of intensive care (ICU), ventilated adults and children were ever meant to be looked after in hospital ICU’s/PICU’s. This is rapidly changing by organisations like INTENSIVE CARE AT HOME proving that nothing could be further from the truth.
We have taken Patients home directly from intensive care (ICU/PICU) and continue to do so. For more information, please read our case studies here
INTENSIVE CARE AT HOME case studies
2. Look for an organisation that has a clear and proven plan when it comes to home ventilation and tracheostomy
Again, looking after your loved one on mechanical ventilation and tracheostomy takes specialised skills, expertise, know-how and a “can-do” attitude.I know you and your family are looking for a transition home from intensive care (ICU/PICU) that is frictionless.I know that having a loved one in ICU/PICU causes more than enough friction and you don’t need any more friction than you are already experiencing.
Therefore, chose wisely and choose someone like INTENSIVE CARE AT HOME that has a proven track record to successfully transitioning ventilated and tracheostomised adults and children home from intensive care (ICU/PICU)
We work according to the evidence based home mechanical ventilation guidelines which gives a proven framework and also gives clear guidelines about the level of quality required at home for services like INTENSIVE CARE AT HOME, I.e. it exclusively requires ICU/PICU nurses with a minimum of two years ICU/PICU experience, ideally with a post-graduate critical care certificate or equivalent.
Evidence based Mechanical home ventilation guidelines
3. Choose only accredited and certified services that are accredited for INTENSIVE CARE AT HOME services
When we first started operating, we realised quickly that there are some ventilated Patients at home with tracheostomies that are looked after by non-ICU/PICU nurses or even worse, they are looked after by support workers.
The unfortunate reality of it is that these organisations are literally flying blind and they have no idea of what they are doing. This results in Patients dying or being readmitted back to ICU/PICU on a frequent basis, defeating the purpose of such a service.
Looking after ventilated and tracheostomised adults and children requires the skills of ICU/PICU nurses and everything beyond this skills level is life threatening for the Patients.
It’s like flying a plane without a pilot.
Therefore, you need to look for 3rd party accredited services like INTENSIVE CARE AT HOME so that your loved one can stay in a regulated environment that provides high quality standards.
High quality standards need to be verified by independent 3rd parties and that’s exactly what we do.
As far as we know and at the time of me writing this article no other organisation has achieved 3rd party accreditation for INTENSIVE CARE AT HOME and no other organisation has built more intellectual property in this space than INTENSIVE CARE AT HOME.
Find out more about our accreditation and quality standards here
4. Look for an organisation that is reliable and has integrity
This should go without saying.
However, once again, just like I explained in 3) many organisations don’t know what they are doing when it comes to mechanical ventilation and tracheostomy in the home.
This starts from having a fully covered 24/7 nursing roster with a back up plan and it continues on an integrity level.
Providing a 24/7 roster takes effort and integrity and very few organisations have it.
When we first started out we started with a client that was looked after in the community on a ventilator with tracheostomy. This client was looked after by a mixture of non-ICU trained nurses and support workers. Therefore the client had weekly ICU readmissions either because the general (non ICU trained) nurses and the support workers were simply lacking the clinical skills to look after the Patient and the client also went back to ICU because of no staff.
Think about it, a support worker might as well stock shelves in a supermarket rather than looking after someone needing ICU or PICU level of care for the same amount of money without having someone’s life in their hands.
Why would they take that risk?
5. Look for an organisation that exclusively works with ICU/PICU nurses in order to facilitate ICU AT Home
Just like I mentioned in 2) where I made reference to the evidence based mechanical home ventilation guidelines, ventilated adults and children with tracheostomies exclusively need the skills of intensive care nurses that have worked in ICU/PICU for a minimum of two years.
Anything less than having ICU/PICU nurses look after your loved one on a ventilator is putting their life at risk and will result in hospital readmissions or even death.
Your loved one will exclusively have ICU nurses look after them in ICU so why would anyone change this outside of ICU if the clinical requirements are the same?
If organisations claim they can provide this service without ICU/PICU nurses they are run by non-clinical people and they are usually driven by greed and their profit margins.
They don’t know what it takes to look after this highly vulnerable Patient population at home on ventilation and tracheostomy.
They put money before lives.
INTENSIVE CARE AT HOME is run by intensive care professionals and surely we need to make a profit too to stay in business, but our clients and their needs are first and foremost.
6. Look for an organisation that can advocate for you and your loved one
Many intensive care units still claim that intensive care at home can’t be done and that there is no funding for it.
Nothing could be further from the truth as we have proven over and over again.
How did we get there?
Simply by advocating for our clients.
We know that we can safely take our clients home from ICU/PICU and we also know the value of our service.
We’re cutting the cost of a $5,000-$6,000 per bed day ICU/PICU bed by 50% and therefore we’re creating a win-win situation.
Health funding agencies have an interest in that.
We therefore have helped many families in intensive care (ICU/PICU) to access third party funding they thought was not accessible to them.
7. Look for readmission rates back to Intensive care (ICU/PICU) when it comes to mechanical home ventilation with tracheostomy
Just like I mentioned in 4) and like it’s documented in the mechanical home ventilation guidelines, you can only provide INTENSIVE CARE AT HOME services to ventilated and tracheostomised adults and children with ICU/PICU nurses with a minimum of two years ICU/PICU experience with a post-graduate critical care qualification.
If anyone provides services below the evidence based recommendations and guidelines they are putting clients and Patients at risk and they are having multiple readmissions back to ICU/PICU.
This makes sense given that ventilation and tracheostomy requires the skills of ICU/PICU nurses.
Again, we know from experience that the few organisations that provide services below what’s clinically recommended and what’s clinically safe have high readmission rates back to ICU/PICU.
Here is one of our case studies of one of our clients in how we stopped readmission to ICU to zero for one of our clients
- A YOUNG CLIENT WAS GOING BACK TO INTENSIVE CARE REGULARLY! INTENSIVE CARE AT HOME PUT A STOP TO IT, IMMEDIATELY!
8.Look at a proven track record to weaning ventilation and tracheostomy at home
The overwhelming majority of Patients in intensive care (ICU/PICU) need a ventilator temporarily.
Most Patients at home need a ventilator for the rest of their lives but certainly not all of them.
Again, we also have experience in having Patients weaned off ventilation and tracheostomy at home.
Rather than being weaned off ventilation and tracheostomy in ICU/PICU we can wean your loved one off it at home if the clinical condition allows.
For example, conditions like Guillan Barree syndrome don’t require a 6-12 month ICU admission. The weaning process can be done at home also.
Again, have a look at a case study of one of our clients here
- INTENSIVE CARE AT HOME services for a 15 month old toddler, another “win-win” situation and success story
And if your loved one is going home for end of life care, make sure the organisation you’re engaging with has experience in end of life care for intensive care (ICU/PICU) Patients as well.
INTENSIVE CARE AT HOME has experience in end of life care or palliative care at home for ICU/PICU patients.
Have a look at our services and another case studies here
- MARY IN HER LATE SIXTIES SPENT THE LAST YEAR OF HER LIFE AT HOME DESPITE BEING INTERMITTENTLY VENTILATOR DEPENDENT AND ON CHEMOTHERAPY!
- Quality of-end-of- life nursing services for mechanically ventilated Adults with Tracheostomy as a genuine alternative to Intensive Care
9. Look at signs that quality of life can be provided at home that is not possible in intensive care (ICU/PICU)
When long-term ventilated adults and children are stuck in ICU/PICU all they want is to go home and we understand that.
The comfort of one’s home can never be replaced anywhere else.
But besides leaving ICU/PICU and going home what else can be provided at home that hospital ICU’s can’t provide?
The answer is simple. Look at what quality of life is possible at home, I.e. can children go back to kindergarten or school? Can adults potentially go back to work or at least work from home?
This is all achievable with the right support structure and no intensive care unit can provide more than clinical care.
INTENSIVE CARE AT HOME can provide the clinical care as well as the quality of life aspect of care that can not be provided in a sterile intensive care (ICU/PICU) environment!
10. Look for an organisation that is run by ICU/PICU professionals and not by business people
Some organisations that are run by big business conglomerates also provide services for ventilated Patients at home.
This is dangerous like I mentioned in 3)
They are the organisations that operate with non-ICU trained nurses or even worse with support workers. They do this to maximise their profit margins without knowing what’s clinically required for Patients on ventilation with tracheostomies.
In order to safely provide INTENSIVE CARE AT HOME services for ventilated adults and children with tracheostomies you need ICU/PICU nurses with a minimum of two years ICU/PICU experience ideally with a post-graduate critical care certificate.
This is more expensive than general and non-ICU trained nurses and it’s also more expensive than support workers.
INTENSIVE CARE AT HOME is still by far more cost effective compared to the $5,000-$6,000 per bed day intensive care (ICU/PICU) bed and it’s clinically safe as per the mechanical home ventilation guidelines.
Therefore, looking after mechanically ventilated Patients with tracheostomies takes a team of ICU/PICU nurses and nothing less.
You will need people that can advocate for you and for your loved one just like I mentioned in 6)
So don’t fall prey for the big corporates driven by greed who are run by business people not knowing and understanding what’s clinically required for your loved one.
Look for services like INTENSIVE CARE AT HOME that is run by intensive care professionals.
If you want to find out how we can help you to get your loved one out of Intensive Care including palliative 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, if you want to know how to get funding for our service or if you have any questions please send me an email to [email protected] or call on one of the numbers below.
Australia/New Zealand +61 41 094 2230
USA/Canada +1 415-915-0090
UK/Ireland +44 118 324 3018
Also, check out our careers section here
We are currently hiring ICU/PICU nurses for clients in the Melbourne metropolitan area, northern suburbs, Mornington Peninsula and in South Gippsland/Victoria.
We are an NDIS, TAC (Victoria) and DVA (Department of Veteran affairs) approved community service provider in Australia.
Also, have a look at our range of full service provisions here
We have also been part of the Royal Melbourne health accelerator program for innovative health care companies last year!
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!