The tele-health initiative started in 2012, aiming to improve the support and care to critically ill patients in south-west Victoria, and provide support to University Hospital Geelong ICU for critically ill children and patients receiving ECMO treatment, using a heart-lung bypass machine. This includes;
- Video-conference clinical consultation between University Hospital Geelong and Hamilton Hospital, Portland Hospital, Royal Children's, and The Alfred, to assist in the care of critically ill patients
- Video-conference clinical review meetings between University Hospital Geelong, the Hamilton Hospital and The Alfred.
Patients with heart and/or lung failure require a heart-lung bypass machine. The use of extracorporeal membranous oxygenation (ECMO) to treat severe adult cardiac and respiratory failure has increased in the last decade due to supportive evidence, advances in extra-corporeal technology, and increased clinical experience.
In 2011, University Hospital Geelong implemented a structured ECMO program. This included intensivist training in intravenous cannula tube insertion and care for the ECMO patient, nurse credentialing in the maintenance of ECMO, updating equipment, establishing a formal relationship with a high-volume ECMO service, and regular audit cycle.
This innovative communication program has trained doctors and nurses to comfortably approach what have been traditionally difficult conversations around end-of-life care.
The iValidate™ program provides a structure that was developed by experts in communications, ethics, end-of-life care and clinical leaders from Barwon Health and Deakin University. It includes a two-day interactive small group advanced communication course (based on the Calgary-Cambridge model, delivered by trained local faculty), and a process of care and documentation that supports this.
By participating in this course, doctors, nurses and allied health professionals will obtain the necessary communication skills to determine a patient’s goals, values and preferences, provide medical advice and ultimately help decision making regarding appropriate medical care. Sharing decisions between patients, family and health professionals leads to patient-centred care rather than the more traditional care directed toward disease focussed outcomes.
Initial data has shown that iValidate™ leads to significant improvements in patient-centred care, while not affecting access to critical care or outcomes in quality and longevity of life.
Going forward, iValidate™ will continue to train doctors and nurses to create a broader base of expert communicators. When combined with the system to encourage shared decision-making, we believe we will continue to change the culture, and improve medical communication all around.
Pilot data shows iValidate™ leads to significant improvements in patient-centred care, reduced MET calls (emergency response), while not reducing access to ICU or changing survival.
There are other benefits in training our health professionals to communicate. These include better dispute resolution, inter-professional interaction, and foundation skill acquisition for other areas, eg open disclosure.
Last Modified: Thursday, 02 April 2020