New ICU and Telemetry Unit
Take Critical Care to a New Level

Most are patients with life-threatening conditions – such as heart attacks, strokes, neurological disorders, trauma, renal failure and respiratory distress – who are transferred from the Emergency Department (ED) to the ICU or TU for continuous monitoring and immediate intervention as needed.

Larger space close to ED
In September, the Intensive Care/Telemetry Unit will move into spacious new quarters in the southeast wing of the hospital's main level. The new 22,000-square-foot addition will more than double the unit's space and be much closer to the ED on the lower level.

"Getting to the current ICU and TU requires a rather long hallway trip with a six-floor elevator ride up from the ED," explains Adam March, RN, BSN and manager of ICU/Telemetry. "Having the new unit on the main level means that we're just a quick tunnel ride and one level up, which is important when treating critically ill patients."

The new area, which is a key part of the hospital's $45 million expansion project, will house eight ICU rooms – three of which are isolation rooms with negative airflow – for the hospital's most critically ill patients. Adjacent to the ICU will be the 22-room Telemetry Unit for patients who require continuous heart monitoring but are considered to be more stable than those needing intensive care. All 30 patient rooms are private and share critical care staff and technology.

Designed for healing
Designed with input from clinical staff, the unit incorporates a hub-and-spoke design with a large nursing station in the center surrounded by patient rooms.

In constructing the new ICU/TU, hundreds of miles of cables and wires were installed to not only provide the latest medical technology required to sustain life, but also to allow for future expansion. Besides having computers in every room so that staff can chart patient progress without leaving the patient, there are numerous hookups for various treatments.

"People don't realize how much is incorporated into these walls," points out Mike Parker, the hospital's construction director. "There's oxygen, medical gas, vacuum and special bed hookups so the lights and TV can be controlled from the bed."

Even the foundation of the addition was constructed with patients in mind. To absorb any possible vibrations from road traffic on Michigan Avenue 70 feet away, a silicone seal was put in place between the foundation floor and walls. Creative landscaping with trees and evergreens lends privacy while giving patients a pleasant view.

The larger ICU rooms were intentionally designed with extra space to accommodate monitoring equipment and medical teams meeting with patients. The extra elbow room also allows physical and occupational therapists to move about with ease while working with patients.

"Our ICU is a multi-diagnosis center," March points out. "A large variety of patients come through our doors with one thing in common: they require immediate, critical care and monitoring." ICU staff is specially trained in cardiac intervention, neurosurgery, multi-system failure and other high-risk conditions.

All 30 rooms have another feature that promotes healing: "They are designed around the patient and the caregiver, and also the family," says Parker. Besides private, family-friendly patient rooms, the unit offers a visitors lounge with comfortable seating, a vending area and even a shower. Smaller waiting areas give family members a private place to meet with physicians and other caregivers.

When the hospital's expansion program is completely implemented (in 2008), a totally hands-free wireless communication system will be in place. The high-tech, futuristic system responds to voice commands and will allow staff members to speak to each other or patients with the touch of a button. The system will be linked to the patients' nurse-call system so that staff members can answer and respond immediately to a patient's needs.

Over the next few weeks, all new equipment will be installed and staff will prepare to occupy the new space. And while the ICU/TU will inevitably lose its old moniker of 6-West, the new area will allow staff to provide an even higher level of care to patients.

A Critical Connection for Joann

While a patient in the ICU, JoAnn Kidd, seated, developed a rapport with her caregivers. Two years ago, Holland resident JoAnn Kidd was admitted to Holland Hospital after developing septic shock due to abdominal problems. The 76-year-old, who has no immediate family in the area, was gravely ill but too sick to know it. Her daughter-in-law called her from North Carolina and was so concerned that she dispatched an ambulance to take JoAnn to the hospital. For the next 34 days, the hospital's Intensive Care/ Telemetry Unit on 6-West would be her home, and the staff there would become her family. Near death when she arrived, JoAnn required surgical procedures, daily open-wound cleansing, a ventilator, and multiple medications and IV drips. When she improved enough to be moved to a different floor, she became distraught over leaving her new friends. Her medical team had a conference, and decided it was best to keep JoAnn right where she was: on 6-West. On her discharge day, the staff held a parade in JoAnn's honor, complete with confetti. "Everyone was so sweet to me. They are just like family, and we stay in touch," says JoAnn. "I just love them all."

Keystone ICU: Saving Lives

Each year, more than 5 million people are treated in hospital intensive care units (ICUs) in the United States. This high level of critical care costs $180 billion a year, or about one-third of total acute care spending annually. So it is no surprise that improving delivery of care and reducing medical errors in ICUs – which results in better patient outcomes and improved financial performance – has become a nationwide concern.

In 2004, Holland Hospital became one of 70 hospitals participating in an innovative statewide program known as Keystone ICU that offers "best practice" interventions for ICUs. Sponsored by the Michigan Health & Hospital Association and patient safety experts from Johns Hopkins University, the voluntary program is designed to improve patient safety and quality of care, reduce hospital stays, and lower unnecessary or avoidable medical costs.

Hospitals participating in Keystone ICU report significant and measurable clinical improvements, including the reduction of bloodstream infections and ventilator-associated pneumonia – both of which present risks to ICU patients and contribute to patient mortality.

Carolyn Schaefer, RN, MS and director of Acute and Critical Care Services at Holland Hospital, notes that one of the chief reasons Keystone ICU is successfully meeting its goals is that it advocates the use of a multidisciplinary team to manage patient care.

"This involves a core group of staff along with critical care physicians who provide oversight of the management of each patient," she explains. "The team conducts daily patient rounds, which gives them the opportunity to develop daily goals so that the patient progresses.

"It's a collaborative approach that involves physicians, nurses, respiratory therapists, pharmacists and the clinical manager," Schaefer continues. "The team works together to plan the most effective care for the patient, which improves communication so that nothing is overlooked or missed that could pose a risk."

Nurse Educator Kara Heck, RN, BSN, who is closely involved with the project, notes that as one of the original Keystone participants, Holland Hospital has helped lead the way in patient safety initiatives. "We were already doing many of the interventions, and are really ahead of many other hospitals in addressing patient safety," she says.

The benefits of the Keystone project have been so impressive that now more than 125 ICUs in the state participate, making it the largest regional partnership of ICUs ever involved in a single initiative. The outcomes are impressive: from March 2004-2007, the results for ICU patients of hospitals involved in the project are:

• Patient lives saved: 1,729
• Hospital days saved: 127,857
• Health care dollars saved: more than $246 million

Home>