Tele ICU

1. ENHANCING PATIENT SAFETY AND NURSING CARE EFFICIENCY IN APOLLO HOSPITALS: A SERVICE EVALUATION PROJECT OF
APOLLO’S ENHANCED CONNECTED CARE PROGRAM
Presenting Author: Dr K Hima Bindu
Co-Authors: Dr Sai Praveen Haranath, Dr Rahul Khandelwal, Professor Ravi Prakash Mahajan, Dr K Subba Reddy, Dr Prashant Janjal
Introduction and Background:
 Remote patient monitoring can detect vital signs data in real-time, detect patterns of deterioration, and generate alerts for healthcare providers.
 Remote Patient Monitoring is enabled by connected care, which is the real-time electronic communication between patients and healthcare providers.
METHODOLOGY
 ECC service was implemented in 10 different
Apollo Hopsitals. The study was conducted
at Apollo Hyderguda and Jayanagar.
 The period of evaluation was between April
2023 to June 2023.
 The aim of this project is to evaluate the
impact of the ECC on patient safety and
nursing efficiency.
 The project measured the impact of ECC on
patient safety parameters such as the number
of ECC alerts generated that required
intervention, admissions to critical care, and
the number of code blue calls.
 The project evaluated the nursing care
efficiency by analysing the minutes spent on
managing alarms from the intervention vs.
the minutes spent on routine monitoring.
 From the hospital records & the data
collected for routine quality monitoring, we
collected the information on the safety
parameters during the 3-month evaluation
period after implementing ECC in the given
hospital.
 Same data was collected for the three
calendar months before implementing ECC.
Figure 1 shows the wearable biosensor patch and dozee device
Figure 2 shows the display of patient vital signs on dashboard
Figure : Workflow of continuous patient monitoring
Impact of ECC on Patient Safety & Nursing Efficiency
 The ECC alerts generated were higher in number.
 Our finding suggests that ECC led to a higher rate of
identifying critical alerts.
 This proactive intervention offered by ECC led to the
decreasing the need for ICU admissions and decrease in
code blue calls
 The implementation of a wireless vital sign monitoring
system not only reduces the time required to take the vital
signs, but also optimises the Rapid Response System (RRS)
by minimising a delay in RRS activation and enhancing
patient safety.

2. Metrics
Baseline
Period
Interventi
on Period
Total number of
emergency room to
ICU and HDU
admissions 1501 294
Total number of ICU
admissions 2093 1491
Total Number of
code blue calls 13 2
Total number of
MET Calls 24 53
Metrics
Baseline
Period
Intervention
Period
Total number of emergency
room to ICU and HDU
admissions 1501 294
Total number of ICU
admissions 2093 1491
Total Number of code blue
calls 13 2
Total number of MET Calls 24 53
Metrics
Baseline
Period
Intervention
Period
Total number of
emergency room to
ICU and HDU
admissions 1274 368
Total number of ICU
admissions 1597 623
Total Number of code
blue calls 6 4
Total number of MET
Calls 24 42
Alert Type % n
Tachypnea 34% 14
Hypoxemia 27% 11
Tachycardia 22% 9
Bradycardia 12% 5
Bradypnea 2% 1
Hypertension (HTN) 2% 1
Key Interventions % n
Doctor Consultation taken 46% 19
Oxygen Therapy 12% 5
Nebulization Advised 10% 4
Infection/Inflammation 10% 4
Suctioning Done 10% 4
Tachycardia 7% 3
Multiple Co-morbidities Patient 2% 1
Elderly patient 2% 1
Locations Number of
ECC Alerts
Generated
which
required
Intervention
Number of
Admissions to
Critical Care
from Ward
Number of
Code Blue
Calls
Average Time
Spent on
Manual
Monitoring
(Min: Sec)
Average Time
Spent on ECC
Monitoring
(Min: Sec)
Apollo
Jayanagar
1034 21 3 03:05 02:25
Apollo
Hyderguda
920 45 0 03:37 02:19
Table 1: ECC Patient Safety and Nursing efficiency
Table 2: Apollo Jayanagar Table 3: Apollo Hyderguda
Table 4: Specific Alert Triggers
Table 5: Key Nursing Interventions
Documented