The 24/7 Virtual Care Intensive Care Unit Support Project aims to implement a 24/7 electronic ICU (elCU) model of care in two Level 4 Intensive Care Units (ICUs) in regional NSW. Inspired by the success of the virtual care ward rounds at Campbelltown ICU during the COVID-19 pandemic, the project focuses on providing continuous specialist support and enhancing the quality of care in Level 4 ICUs. The elCU model enables remote consultations and virtual ward rounds ensuring timely access to specialist input by leveraging existing resources and integrating telehealth technology. The service addresses the unique challenges faced by rural ICUs and has had a positive impact on patient outcomes, clinician satisfaction and the overall healthcare system.
Enabling independent high-level care
To enhance patient care, the implementation of the 24/7 eICU model of care was rolled out on two Level 4 ICUs in regional NSW. The model increased level 4 ICU capacity and enabled independent high-level care for seriously ill patients including those with COVID-19, by providing specialist consultation support, improving safety, quality and satisfaction. The service also facilitates rapid patient transfers when necessary and benefits from collaboration with experts, data evaluation and implementation assistance. Its success strengthens NSW Health's readiness for future emergencies, improves capacity in rural hospitals and can be expanded statewide and nationally.
Implementation of the eICU model of care
The team accelerated the implementation of a Memorandum of Understanding (MOU) between the Level 5 Campbelltown ICU and two Level 4 ICUs at Goulburn and Bowral as part of the COVID-19 pandemic response. This facilitated collaboration and laid the foundation for further initiatives. The team commenced virtual care ward rounds using telehealth mobile cart computers and a command center at Campbelltown ICU. The team saw positive impacts on patient care and clinician satisfaction during these rounds.
Building upon this success, the team proposed the implementation and evaluation of a 24/7 eICU model of care in two Level 4 ICUs in regional NSW. This elCU model aims to provide 24/7 specialist consultation support to address the limitations in patient care and access to expert advice for clinicians. The implementation of the service involved collaboration with key stakeholders including Intensive Care NSW, the NSW Agency for Clinical Innovation, eHealth NSW and the Health Innovation team at Deloitte. These collaborations ensured linkages with other ICUs, access to independent data evaluation, governance and implementation support.
The proposed model of care has been implemented in phases across local health districts. The introduction of intermittent usage avoids continuous on-call demands for intensivists, provides coverage during leave periods and reduces the need for additional specialists. With sustainability and scalability demonstrated, the eICU model is currently used to support Level 4 ICUs in South Western Sydney Local Health District. It is now ready for implementation in other Level 4 ICUs in regional NSW.
Positive impacts on patient care and clinical satisfaction
With a formal evaluation currently underway, initial feedback from virtual care ward rounds has been promising, demonstrating positive impacts on patient care and clinician satisfaction. This feedback has reinforced the value of implementing the elCU model in Level 4 ICUs.
