Carolinas HealthCare System

Virtual Critical Care Decreasing Length of Stay for Sickest Patients

Nehal P. Thakkar, MD

Nehal P. Thakkar, MD
Virtual Critical Care (VCC)
Medical Director

In just one year, the Virtual Critical Care (VCC) unit has seen some of the nation’s sickest patients, but has found that length of stay is decreased when a new patient is evaluated by the VCC physician within an hour of admission. It’s a goal the team set to achieve when they launched the technology last year.

“We are finding that early evaluation by the VCC intensivist has a significant impact on length of stay,” said Colleen Hole, vice president, Carolina Health Care System Medical Group, Adult Acute Care division.

The Virtual Critical Care technology provides real-time, 24/7 oversight of critically ill patients. Using surveillance technology and two-way audio/video connectivity, intensivists and around-the-clock registered nurses keep a close eye on patients at the Mint Hill facility.

“I still find it fascinating that a critical care physician from Carolinas Medical Center-Pineville can sit in a command center in Mint Hill and help take care of an extremely sick patient at Carolinas Medical Center-Lincoln in the middle of the night,” said Nehal P. Thakkar, MD, VCC medical director.
Sandy Arneson, RNII, CCRN, couldn’t agree more. She has the unique perspective of seeing the VCC from both sides – one as a nurse at CMC-University benefitting from the VCC and also as nurse watching the patients from Mint Hill.
“It is a comfort for me when I am at the bedside to know that another physician will be looking in on my patient and filling in any gaps in the patient care,” said Arneson. “On the other side of the camera, I love having a physician look in so quickly on a patient so that as I am admitting them and getting to know their diagnosis, we can see how we can help immediately and also for their plan of care.”

In a recent Carolinas HealthCare System study, the team looked at six months of data showing length of stay for patients evaluated by the VCC physician within the first hour versus those without an evaluation:

  • Out of 1,395 hospital patients, those without an evaluation stayed an average of seven and a half days compared to six days for those with an evaluation in the first hour.
  • Out of 2,273 ICU patients, those who were evaluated within an hour saw a decrease in the length of stay from three, to two and a half days.

Carolinas HealthCare System launched the VCC at three hospitals on May 7, 2013 and has now grown to ten hospitals. The VCC now watches 140 ICU beds including the new adult Blood and Marrow Transplant unit at Carolinas Medical Center. Plans are underway in the next year to add 160 more beds at Carolinas Medical Center, Carolinas Medical Center-NE and Roper St. Francis.

“Through the VCC we have been able to identify aspects of critical care that we do very well, but also areas where there is variability in practice and opportunities to improve quality,” said Dr. Thakkar.

The team is working to identify evidence-based best practices to share across the System.