Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 12, 2020
Date Accepted: Aug 10, 2020
Date Submitted to PubMed: Aug 15, 2020
Rapid Implementation and Innovative Applications of a Virtual ICU during the COVID-19 Pandemic: A Case Study
ABSTRACT
Background:
Coronavirus disease-2019 (COVID-19) necessitated the rapid increase of highly infectious disease intensive care unit space.
Objective:
The Virtual Intensive Care Unit (vICU) at Houston Methodist Hospital (HMH) was utilized amidst the 2019 novel coronavirus disease (COVID-19) outbreak. This paper details novel adaptations and rapid expansion of the vICU applied towards patient-centric solutions while protecting the staff and patients’ families during the pandemic.
Methods:
Planned vICU implementation was redirected to meet emerging needs of COVID-19 intensive care units’ conversion, including alterations to staged rollout timing, virtual and in-person staffing, and scope of application. With the majority of hospital critical care physician workforce redirected to rapidly expanded COVID-19 ICUs, the non-COVID-19 ICUs were managed by cardiovascular surgeons, cardiologists, neurosurgeons, and acute care surgeons. HMH expanded the vICU program to fill the newly depleted critical care expertise in the non-COVID-19 units to provide urgent, emergent, and code blue support to all ICUs.
Results:
Virtual family visitation via a Consultant Bridge, palliative care delivery, and specialist consultation for COVID-19 patients exemplify the successful adaptation of vICU implementation. COVID patients, isolated and separated from their families to prevent the spread of infection, were able to virtually see and hear their loved ones, bolstering the mental and emotional status of those patients. Many families expressed gratitude for the ability to see and speak with their loved ones. The vICU also protected medical staff and specialists assigned to COVID units, reducing exposure and conserving personal protective equipment.
Conclusions:
Tele-critical care has been established as an advantageous mechanism for the delivery of critical care expertise during the expedited rollout of vICU at Houston Methodist Hospital. Overall responses from patients, families, and physicians are positively in favor of continued vICU care; however, further research is required to examine the impact of innovative applications of tele-critical care in the treatment of critically ill patients.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.