Consider the life cycle steps identified in this document and how they apply to the article A Health System-Based Critical Care Program With a Novel Tele-ICU: Implementation, Cost, and Structure Details. For example, resources are planned, designed, implemented, and evaluated. What resource requirements are needed to accomplish the program, and how are they justified?
In your responses, state whether you think your peers effectively justified the resource requirements for the program. Why or why not? Offer suggestions for improvement, citing the CDC program life cycle framework.
Starting up a new healthcare program within a preexisting program can be a challenge. This requires careful strategic planning and allocating available resources for the best possible outcome. Using the logic model will create a visual on the planning, implementation, and evaluation. “Ideally, the development of a logic model engages and guides program development and evaluation planning simultaneously (Step2B, 2021).” The article focuses on hospitals within the Fairview Health System (FHS). They have designed a program using telehealth to lower the risk of patients needing critical care services by being more readily available to their patients.
“Improving the efficiency of critical care service is needed as the shortfall of intensivists is increasing (Fortis et al., 2014).” The article describes what their current problem is and a solution they have proposed, telehealth. It states that there needs to be some improvement in their critical care facility, which they believe telehealth will improve their general outcome (Fortis, 2014). Thanks to telehealth, now intensivists can view their patient’s EMR’s without them being in the facility, give them feedback, answer questions, and have their patient’s charts ready. Studies showed that mortality decreased and improved their patients’ overall outcomes since implementation.
When the Fairview Health System was looking to improve efficiency of its ICUs out of a need due to limited intensivists, a tele-ICU program was developed that would allow for implementation of a remote ICU program and standardization of critical care practices across ICUs. The life cycle steps/ logic model can be used to represent program outcomes and show how the program will reach these outcomes, while portraying the logic for these program expectations. Steps of logic model include definition of the problem, capacity/ resource/ haps inventory, definition of activities, if…then process, arrange logic model components, and logic model narrative.
Due to the lack of intensivists available within FHS, and data showing that intensivists improve outcomes for ICU patients, a need was demonstrated to implement changes to the current ICU program. Rather than using existing telemedicine programs that would have licensing fees and additional potential associated operating costs, FHS set out to create a tele-ICU program using “off the shelf” technology that would allow intensivists to share clinical responsibilities and reduce the costs of the remote ICU program. Intensivists also have the ability to access the EMR data remotely, giving them the same insight into health information as if they were on-site. This was all part of the goal of reducing the overall per-bed cost (increasing efficiency). Overall, the study seems to have accomplished what it set out to do, and it started out with the identification of a problem, setting goals, planning resources, etc. which are part of the basis for the steps set out in the logic model document.
–Andrew