b'Modern Operational Strategies: Proven tactics to reimagine care Shiftingtoanewparadigm,isacriticalfirststepin COVID made it clear that telemedicine should be approaching a new way of thinking in the ICU. However,integrated into the brick-and-mortar operations of to accelerate the evolution we must also deployphysician service lines. Forward-thinking critical care integrated operational strategies to create immediateprograms will include teleintensivist coverage as a efficiencieswhilealsooptimizingcostsincluding:standard provision that can be implemented as a wrap-1) Expanded role of physicians, virtual healtharoundcoveragemodelforonsitestaffingorintegratedand teleintensivists, 2) Optimized APP scope andon an as-needed basis. The question for the hospital responsibility,3)Integratedstaffing,andshould not be whether to use teleintensivist care but 4) Modernized nurse training. when.1)Expanded role of physicians, Virtual Health The three major areas to consider when implementing and Teleintensivists telemedicine are quality, access, and cost: 1Physician services groups tend to place a singularQuality/Access:emphasis on recruiting. Since their inception, theseEarlyinterventionbyboard-certifiedorboard-companies were formed to recruit clinicians for theireligible intensivistprograms. In some sense, it has been their primaryBedside nurse mentoring in real-timefunction. A hospital needs certain services performed;Care targeted to when and where it is neededitisuptothephysicianservicesgrouptofindpeopleto Cost/Access:provide those services. Logistical support for ICU admission and discharge Intodaysenvironment,weknowitisnotsosimple. to optimize throughputPreviously, we may have talked about a recruitingSupervision of advanced practice providersstrategy, but today the C-suite must think moreRemoving geographical barriers to the expertiseholistically.AnoperationallyefficientICUmustprioritize of intensivistthreestaffing-relatedtaskstobefinanciallysuccessful Cost/Quality:both now and overall: Standardization and adherence toevidence-based care1.Recruit the right people Earlyidentificationofdeterioration2.Retain the right people Reducing post-acute care costs3.Leverage telemedicine Finally, many system leaders have asked me how I was Withouteffectiverecruitingandretention,itistooeasy able to make programs successful that had struggled in to fall into the trap of thinking that a modern technologythe past. I always tell them that it is not me who made it solutionwillbeasilverbulletforstaffingproblems.Too successful,butacomprehensivestrategytofind,retain,many technology companies today promise to solveand grow the right people, those with the relationship-theclinicalstaffingcrisis,whetherthroughagig building skills, passion, and attention that are the secret approachtoclinicalstaffingorbyleveragingproprietary sauce of any overly complex hospital service and most (but now widely and increasingly available) platformimportantly, the clinical professionals were aligned with technologies. There is no substitute for a strategy thatthe C-suite.prioritizes permanent, onsite clinicians dedicated to2)Optimized APP Scope and Responsibilitytheir local communities.Many hospital leaders understand there are potential Of course, it is equally foolhardy to ignore or devalue thefinancialbenefitstoexpandingAPPresponsibilityinenormous potential for new telemedicine technologytheir ICUs. However, hospital structures and processes that is applied and deployed on a broad set of use cases,oftenhandicapthisapproachwitholdwaysofthinkingmany of which were not feasible even just a few yearsand antiquated paradigms remaining as institutional ago. Together, we heal constraints. Interestingly, if we compare a critical care Together, we heal 4Together, we heal SCP HEALTHIBRINGING THE C-SUITE TO THE BEDSIDE IN CRITICAL CARE MEDICINE'