Customer
Customer
Customer
Customer
CRDR
De-Identified Identified
Discovery PBI
TSI PremierOn
Core
VIPER Epic
HCAPS UHCPress
Gainey
Customer
Customer
Customer
Customer
Cu
sto
me
r S
erv
ice
To
ols
& T
ech
CRDR
De-Identified Identified
Discovery PBI
TSI PremierOn
Core
VIPER Epic
HCAPS UHCPress
Gainey
Customer
Customer
Customer
Customer
Cu
sto
me
r S
erv
ice
Tools
& T
ech
CRDR
De-Identified Identified
Discovery PBI
TSI PremierOn
Core
VIPER Epic
HCAPS UHCPress
Gainey
A Single Patient’s Experience
5-day default patient view
Full hospitalization view
Multiple hospitalizations view
1
4
3
2
Palliative and End of Life Care
“I was rounding in 11 NP and noted a patient whose rothman index was in the red that was in a
decline (47.5 to 28.7). I spoke with the RN who shared with me the patient has had a change in
MS. I further evaluated the patient and found him to be tachypneic, tachycardic and hypoxic. The
patient was being taken off the floor for a cardiac echo. I stopped the transfer. The patient's
skin color was ashen and he was unable to speak based upon his shortness of breath. I suggested
to the PA that we obtain an ABG : 7.51/24/57/18.2/91.2. The wife decided (pt was 56 with end
stage cancer) not to intubate and place him on a ventilator. He was made comfort measures.
This could have had a different outcome if the patient had coded and was intubated with an
admission to the ICU. This would have been traumatic not only to the patient but the
family as well.”YNHH SWAT Nurse e-mail , Mon 6/4/2012 9:59 AM
Better Patient Care Leads to
Reduced Variation in Cost
Case Type
Oncology patients with at least one overnight stay transferred to ICU and expired in ICU
Cost Savings
Intervention
RRT Nurse consults RI prior to transfer, immediate intervention, patient not transferred, receives Palliative Care
measures in Oncology Unit and expires on Oncology Unit
Non Intervention Cases
95 patients, at least one overnight stay on the Oncology Unit, then transferred to and expired on ICU (7/11/11 – 5/31/13)
Cost and Goal Metrics
• Patients transferred to ICU and expired: Total cost per case $30,965
• Patients not transferred to ICU and expired: Total cost per case $5,590
• Cost difference per case: Difference: $25,375
• GOAL: 50% of transferred patients receive palliative care
$1.27M