Lack of reimbursement and low utilization create unsustainable costs
Bangor, Maine – Earlier today, Eastern Maine Medical Center announced the discontinuation of its Critical Care Connection service, effective June 20, 2014. Since 2008, the program has connected nurses caring for patients in the region’s intensive care units with EMMC critical care nurses and specialists for real-time, multi-disciplinary critical care support.
“This decision was not made lightly,” says James Raczek, MD, FAAFP, EMMC senior vice president, chief operating officer, and chief medical officer. “As the tertiary care provider for the northern two-thirds of Maine, the Critical Care Connection allowed us to partner with regional hospitals to help patients receive care closer to home. Unfortunately, the lack of reimbursement for this service limits the number of hospitals who can participate, making the overall costs for the program unsustainable,” Raczek notes. With nine hospitals participating in the program, EMMC is currently monitoring on average fewer than three patients throughout the region each day.
EMMC has notified the nine participating hospitals and will work with their care teams to ensure the transition away from the Critical Care Connection is as smooth as possible. “Since the Critical Care Connection was established, we’ve developed other regional services such as EMMC’s Telemedicine and Transfer Center that will continue to ensure patients receive the right care, at the right time, and in the right place,” adds Raczek. The critical care services provided at EMMC in Bangor are separate from this program and will continue to be offered for patients in the region.
The Critical Care Connection also monitored EMMC’s internal Critical Care and Emergency Department areas. “While this program provided an extra layer of oversight for these patients, it never replaced the remarkable care provided by EMMC nurses at the bedside,” says Jodi Galli, RN, EMMC vice president and chief nursing officer. “Hospitals across the country are delivering high-quality care without this type of monitoring service, and we know we can do so at EMMC as well.” Critical Care and Emergency Department staff will review protocols over the next month in preparation for the discontinuation of service in June.
The teams will also continue to build on the standards that have been put into place to advance patient care at EMMC, including: quality bundles, a set of evidence-based practices that have been proven to improve patient outcomes; 24x7 intensivists coverage; and expanded code teams, a defined group of people that automatically respond when trauma, strokes, and other medical situations arise at the hospital.
Ten full time positions, two part time positions, and one pool position will be eliminated at EMMC as a result of the discontinuation of the Critical Care Connection. EMMC is currently working with affected employees to identify other suitable positions within the hospital.