Helping improve care for patients on ventilators
Dr. Louise Rose’s research is helping inform health-care planning for individuals who require mechanical ventilation. What she’s proposing will not only save the health care system money, it will vastly improve patient care.
One of Louise’s current research programs is based at the Provincial Centre for Weaning Excellence at Toronto East General Hospital, known locally as the Prolonged-Ventilation Weaning Centre (PWC).
“The aim of the game is always to get the patients off mechanical ventilation, or to the least ventilation required for optimal quality of life,” she says.
Dr. Rose’s research program aims to improve the experience of mechanically ventilated patients across the spectrum of care, from the emergency department to the home.
In 2012, the Canadian Respiratory Journal published a retrospective study of PWC that Dr. Rose conducted with Dr. Ian Fraser, one of the Centre’s four respirologists. The study pointed out that unlike in the U.S., Canada’s health-care system doesn’t have financial incentives to transfer patients out of the ICU after 21 days of ventilation. Without a system in place to promptly move patients from the ICU when they no longer need constant, close monitoring, patients can spend more than four times longer in the unit.
There are clear financial benefits to moving stable patients out of the ICU and into a weaning centre. The cost of caring for a patient in the ICU is two to three times greater than it is in the PWC. An even more important reason for a speedy exit from the ICU is that the possibility of weaning from a ventilator decreases over time.
Dr. Rose, who was recently awarded the TD Nursing Professorship in Critical Care Research at Sunnybrook Health Sciences Centre, knows all too well the many complications that can be associated with the prolonged use of a breathing machine. In her more than 18 years of practice in medical-surgical, cardio-thoracic and trauma ICUs, Dr. Rose has seen a full range of complications – from infections, blood clots and bleeding, to heart attacks. Getting patients off ventilators earlier is important because it helps reduce the risk of complications.
(Reproduced with permission from The Pulse magazine.)