BLOOMINGTON — Shelly Roy and Lindsay Widlacki appreciated the extra layer of care their loved one received even though they never met the critical care nurses and doctors providing the additional oversight.
Jordan Roy, 33, of Fairbury, was a patient in the intensive care unit of OSF HealthCare St. Joseph Medical Center for 10 days after surgery after a spinal cord injury.
Throughout his time in ICU, he was cared for not only by hospital nurses and doctors (intensivists) but also by the eICU (electronic intensive care unit) Core in Peoria.
The eICU uses continuous electronic monitoring of patient vital signs and activates audio equipment, cameras and video screens at least twice a day and additionally as needed. Critical care nurses and doctors in eICU Core monitor and help to care for ICU patients at OSF hospitals.
"I think it's a wonderful service. It's definitely reassuring," Widlacki, of Fairbury, Jordan Roy's girlfriend, said on Dec. 29 after Roy was transferred to the post-ICU.
"The ICU nurses (at St. Joseph) are fantastic but they're busy," said Shelly Roy, Jordan's mother. "It gives the family extra peace, knowing there is an extra set of eyes watching your loved one."
The eICU service, called OSF ConstantCare, began five years ago and is used in all OSF Illinois hospitals with an intensive care unit, said Suzanne Hinderliter, OSF vice president of TeleHealth Services.
All ICU patients are admitted into the eICU, Hinderliter said.
From June 2, 2012, through Aug. 31, 2017, 53,852 patients were admitted into the eICU, Hinderliter said.
During that time, patient mortality rates in OSF intensive care units decreased by 26 percent and patient length of stays in intensive care units decreased by 30 percent compared with before eICU monitoring, Hinderliter said.
"These (ICU) patients are really sick and we have decreased complications across the (OSF) system," Hinderliter said. Complications include sepsis (which can lead to a life-threatening drop in blood pressure), ventilator-associated pneumonia, infections and blood clots.
"We had set goals of a 20 percent decline in mortality rates and a 20 percent decline in length of stay so we have surpassed our goals," Hinderliter said.
"That's what we were striving for — achieving better outcomes for our patients," she said. "In my opinion, this has taken care to the next level for these patients."
Results after five years have been comparable at St. Joseph and OSF HealthCare Saint James-John W. Albrecht Medical Center in Pontiac.
"It's going very, very well," said Dr. Venkata Dodda, a St. Joseph intensivist.
"The added support translates to increased excellent care," said Jennifer Peifer, nurse manager of St. Joseph's Comprehensive Care Center, which includes ICU and post-ICU.
"Nursing is constant collaboration," said Sheri Piper, critical care nurse and clinical educator in the Comprehensive Care Center. "This (bedside care combined with eICU monitoring) is the best teamwork out there for the patient."
St. Joseph has five to six ICU patients on a typical day, Dodda said.
Blood pressure, heart rate, respiratory rate, oxygen saturation, temperature and medications of all ICU patients are monitored not only at the hospitals but by the eICU Core, located in the Jump Trading Simulation & Education Center in Peoria.
The Core consists of several work stations with video screens, cameras and audio equipment staffed 24/7/365 by three to four critical care nurses and, additionally, critical care doctors during nights, weekends and holidays when intensivists may not be on site in smaller and mid-size hospitals.
Running behind each patient's vital signs is trending data that may help quickly identify when a patient's condition is deteriorating. For example, the sooner that sepsis is identified, the quicker treatments may begin, Hinderliter said.
"We can monitor for subtle trends in medical conditions," she said.
Nurses and doctors in the eICU turn on cameras and audio to make a visual check of ICU patients after they are admitted, as well as checking their vital signs and IV medications. When they do so, a "doorbell" goes off, a light goes on and the eICU nurse or doctor introduces themselves so patients and family members know that the camera and audio are on and the patient is being electronically monitored.
Some ICU patients may be unconscious so may not be aware of the bell and the greeting, Dodda admitted.
"The family is aware," Peifer said. The bell and the greeting happen whenever staff from the eICU check in, which happens at least twice a day and whenever the patient's condition is deteriorating, Piper said.
Bedside nurses and family members may initiate an eICU visit by pressing a red alert button at the bedside, which prompts an eICU critical care nurse or doctor to appear on the video screen in the patient's room, allowing interactive communication. This happens when there is an emergency and the hospital intensivist isn't immediately available, when the patient's condition is deteriorating or when the bedside nurse has a question.
"If a patient's condition is deteriorating, we can get things started quickly with the eICU while the intensivist is on his way," Piper said.
In other cases, the nurse may simply wish to validate something, she said.
"I want to know, 'Am I doing everything I can for the patient?'" Piper said.
The service complements bedside nursing, nurses and doctors said.
"We are not replacing any bedside nurses," Dodda said. "There is only so much you can do with a camera."
"This doesn't change the care model that's delivered at the bedside," Hinderliter said. "This is adding an extra layer to the care team and allows us to provide standardized care across the geography."
Bedside nurses and doctors and eICU nurses and doctors collaborate and patients' physicians, family members and the patients themselves make final decisions on care.
When the camera is off, it points away from the patient. Because the camera is on intermittently and people know when it's on, concerns about patient privacy have been alleviated, doctors and nurses said.
"Family members," Piper said, "find it comforting knowing that someone else is there."