College News

Saving Lives in the ICU

By Becky Wiese

PRINTER FRIENDLY VERSION

Dr. Jeffrey Huml (‘79) figured out a way to use technology and teamwork to cut mortality rates and ease the length of patients’ stays in the intensive care unit. And he did it after re-examining his goals and values during a week of study and reflection on Notre Dame’s campus through the Executive Integral Leadership (EIL) experience.

Medical Director of the intensive care unit of Illinois’ Central DuPage Hospital, Huml returned to work determined to radically change the organizational culture of his ICU. He launched an initiative that effectively dissolved the department’s medical hierarchy.

Results are impressive. In the past year, his team has greatly improved risk-adjusted mortality rates, which are the statistical probability of who will live or die based on patients’ physiology and health status. In fact, Huml reports that 13.9 patients per 100 who should have died, lived. There was also a better quality of life for those who did survive.

Huml says the approach is based on “empowering educated people, allowing them to act within the boundaries of their licensure, requiring them to act boldly, and allowing them to realize that when they take a stand, even if it’s somewhat controversial, they will be supported.”

One fundamental shift was the implementation of daily multidisciplinary rounds, which involve the nurse, charge nurse, respiratory therapist, pharmacologist, and physician. In addition to fostering a team approach and improving communication, the effort led to effective new protocols, decreased medication errors, and resulted in cost-effective drug utilization that saved $400,000 over the course of the year.

The coup de grâce was an investment in a data collection system which uses a computerized scoring system of patient physiology to provide practitioners with a statistical sense of which patients are most fragile. The combined impact of the initiatives has been staggering: In just one year, length of stay in the ICU decreased 34 percent, average time on life support plummeted more than 50 percent, and the department saved over $4 million. These improvements are in addition to the improvements in mortality rates.

The changes were not made without considerable resistance from many who were more comfortable with the status quo. But Huml reports a noticeable boost in the department’s morale and, even in the midst of a nursing shortage, no nursing vacancies in the critical care unit.

Huml insists that standing up for personal and professional values has “rekindled and reawakened the spirit of medicine. That’s the most important thing for me.”

EIL teaches executives a holistic, values-based approach to the demands of business. Hosted twice a year in the Giovanini Commons for Collaborative Learning, the week-long program is rooted in the work of philosopher Ken Wilber and led by top Mendoza faculty.

 

 

 
 
Copyright © 2005 University of Notre Dame All Rights Reserved Last Updated on: May 27, 2005