IMPROVING ACUTE PATIENT CARE WHILST OPTIMISING COSTS

Ever rising of costs of healthcare delivery and demand for quality and endearing patient care is a subject that has hospital management trying to shift gears and try whatever possible to keep the top and bottom line of their financials healthy.  

 One of the ways to reduce costs without compromising on quality of care is to adopt the “hub and spoke” model in healthcare delivery mechanism. This model can be implemented in two ways:

1.     Referral Model:

A tertiary care centre (hub) associates with smaller hospitals and nursing homes (spokes) in the primary /secondary drainage area. It becomes a centralized resource across the region. These spokes provide primary healthcare to patients whilst referring cases requiring advanced care and interventions to the hub. In this manner, the smaller units can concentrate on non-critical cases and thereby look at volumes at affordable costs, whereas the tertiary care centre can cover the critical care needs across multiple smaller hospitals, at competitive prices.

 It is perceivable that smaller hospitals, with low critical care volumes, would not be able to afford full-time specialists and highly trained nursing staff.

 Then, a high level quality of care could be questionable, again owing to costs involved.

2.     Integrated Group Practice Model:    

In this model, specialists such as intensivists, anaesthetists form a group of like- minded medical professionals and as a team offer their services to hospitals who cannot afford to hire full timers owing to their high costs or then because the low patient volumes do not justify employing full-time specialists. The intensivists for instance, design shared protocols, clinical pathways along with quality and proficiency goals to improve efficacy of the methods.

 Such a group practice helps to maintain and on-line, cost-effective, acute care services. This group operates in a predefined geography (area) such that one amongst the group members is always able to attend to the hospital/patient both on a regular basis as well as during emergencies.   

 This practice can also be extended to off-line services where patients can consult these specialists regardless of location.

           What would the expected outcomes of such practices mean:

a.     Scalable services

b.     Enhanced quality

c.     Saving of costs

·       Cost reduction: Hospitals would find a substantial reduction in costs vis a vis critical care staffing by leveraging a single team of intensivists capable of offering both onsite as well as off-site (tele-ICU) analysis and reportage.

·       Improved results: The  improvement in quality would be notable with better critical care response times and lower rates of infection

·       Flexibility to attend to multiple patients: Considering the tele-ICU model,  as an integrated care team, the intensivists, can quickly adjust to and support effectively manage increased volumes of critically ill patients at other locations too.

In conclusion, such aforesaid practices could offer local high acute services resulting in  benefits to the patient and the healthcare facilities. Healthcare is gradually moving towards meeting patient’s needs of care whenever, wherever and however they need it. This is the future of critical care.

Dhanraj Chandriani

Managing Director

Technecon Healthcare Pvt. Ltd.