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What happens when resources and staffing are dedicated to providing high touch and high compliance with the ABCDEF bundle? How does adequate staffing, interdisciplinary team dynamics, and quality protocols impact patient outcomes and financial benefits? What is the “secret sauce” of successfully weaning patients from the ventilator? Sam Nimah and Phillip Norris share with us the exemplary work happening at Trivent care.

 

A top concern in the critical care community is the staffing crisis. Stay tuned for an episode diving deeper into staffing and the ABCDEF bundle, but this episode we’re going to explore what can happen when a team has prioritized staffing for high human touch and focus on the ABCDEF bundle and ICU rehabilitation.

The painful irony is that we need adequate staffing to provide the ABCDEF bundle, and when the ABCDEF is not practiced, it increases the burden on staff through high world demand from delirium and ICU acquired weakness, increased time on the ventilator and ICU, the inability to transfer patients out of the ICU when care facilities are full, and then readmissions to the ICU when complications from the ICU continue persist.

Throughout the years, I’ve had listeners reach out and say, “I look around my unit, and it doesn’t look like an ICU. It is full of patients that we’ve turned into LTACH patients, but we’re not rehabilitating them. LTACH is full, so they’re stuck here, and we can’t get them out. Yet we’re not providing the care they need to go home and it’s burning us out.”

This episode, I’ve invited representatives from Trivent to share with us the incredible example they’ve set of the benefit to costs, clinicians, and especially patients when an entire team is staffed for and deeply focused on the ABCDEF bundle.

Episode Transcription

Kali Dayton 0:02
Thank you guys so much for coming on the podcast, Philip and Sam, do you mind introducing yourself started with Philip?

Phillip Morris 0:10
Hi, Kali, Thanks for having us. I’m Philip Morris. And I am the Chief Business Development Officer for Trivent healthcare. I served in previous roles with the company as Chief Clinical Officer. So I’ll be discussing some clinical aspects of our of our program today as well.

Kali Dayton 0:25
And you’re a nurse, you come from a nursing background, I do have a background in nursing. Excellent. And Sam.

Sam Nimah 0:32
And I am Sam NEMA, and I am the CEO of Trivent Healthcare and thrilled to be a part of this podcast. Thank you so much for having us, Kali. Absolutely.

Kali Dayton 0:42
So we met at CHEST conference over a year ago. And I was really impressed by Trivent’s, outcomes. Tell us about what Trivent is and how it came to be.

Sam Nimah 0:58
Tell a bunch tell us a little bit about what we do. And then I’ll go into how we came to be

Phillip Morris 1:01
Sure. So we’ve been around for over 31 years, Kali, and Trivent previously was special caring, you know, we’ve rebranded the company now Trivent healthcare, but we are the people that started the company years ago saw a gap in the in the care for these complex ventilator patients.

And that that gap continues to be here. 30 years later, hospitals have a tough time with these patients. They’re very complex, they’re prolonged ventilator dependent patients, they tend to hang out in the ICUs for an inordinate amount of time as you as you well know.

And to this to this point, and continuing into the future, unfortunately, the only solution for the short term acute care hospital has been to discharge to LTACH. And they typically do this early on in the ICU process. And while it sounds like a good idea at first, unfortunately, the outcomes for these patients do not bode well.

These patients across the board and across the country have significantly high readmission rates when they’re discharged early from the ICU to the long term acute care hospital. Those rates usually range in the neighborhood of 35%. Unfortunately, the mortality rates for these patients are not good either. Those also range in the 30 to 35%. range.

So suffice to say about three fourths of the patients that are discharged early to ICU, excuse me early to L tack in the ICU, just don’t do well, they don’t have good clinical outcomes. So our company solution, which has proved itself to be a viable solution is to create an aggressive multidisciplinary unit within the acute care space. And this includes nursing, of course, PT, OT, Speech, Language Pathology, respiratory therapy, all working collaboratively, within this high touch clinical model.

And it’s in the acute care space. Therefore, we get these patients in the ICU as soon as possible, put them in Collaborate them, or excuse me, calling them into this high touch unit in the acute care space, and apply our clinical model. And by doing this, we’re able to achieve. And there’s a lot of moving parts and parts to our secret sauce, if you will.

But by doing this, we’re able to accomplish Wainwright’s that are second to none in the industry, we are weaning and 85 to 86% of these patients. And I say weaning, we’re liberating them, they’re coming off the ventilator and staying off the ventilator are decannulation rates, meaning getting them off, you know, getting the tracheostomy out actually exceeds the national average for ventilator weaning.

So our outcomes are very good. And most importantly, I readmission rates less than 6%. So we have certainly, I think mastered this particular solution for the prolonged ventilator patient. And that’s what we do.

Kali Dayton 4:03
So you took readmission rates that were you said 35%?

Phillip Morris 4:08
Correct.

Kali Dayton 4:09
And you said that you’ve cut them down to 6%.

Phillip Morris 4:12
For those patients in our unit? That’s correct. And the information that we’re sharing comes from definitive health care. They’re consolidator of data from CMS and other payers. And so this is not just us pulling these pulling these numbers out of the air. These are documented numbers.

And, you know, Sam and I had had the pleasure and the privilege, frankly, to go around the country and meet with hospitals. And so we see these numbers and they’re consistent throughout the country. They’re not just in one particular area. Now some areas are worse than others. But these these numbers, these readmission rates, mortality rates seem to be pretty consistent across the country with regard to the LTACH transfers. I don’t

Kali Dayton 4:56
I don’t think anyone for the ICU side sends patients to LTACH understanding there’s a 35% chance they’ll come back. Or a 35% chance that they’ll die out there.

Phillip Morris 5:06
You wouldn’t think so. But you can, you can imagine that hospitals, case managers and social workers are under a tremendous amount of pressure to get these patients out of the hospital and shorten their length of stay. And I get that, however, where I would disagree with a particular hospital’s thought process would be I think it’s short sighted.

So you can get them out quicker, perhaps. But then you’re also looking at 35% of the time, they’re coming back as readmissions with infections and other complications.

Kali Dayton 5:34
So I have families reach out to me sometimes, and a lot of times they’re reaching out towards the back end of critical illness. And they’re saying they can’t get them off the ventilator. They’re so sedated. Do we go to LTACH, what do we do? It is a very conflicting situation for them.

And then I don’t know what to say, because I recognize that LTACHs are very understaffed. I listen to the details of their cases. And I recognize that these patients have a lot of needs, they’re not still in the critical care phase. But they still need a lot of you said high touch, right, they need a lot of support a lot of rehabilitation. And I’m doubtful that they’ll really get that an L tack. So then where do they go.

And so that’s where you guys are stepping in and bringing in the actual care that they need. So they don’t come back to LTACHs, they actually survive and are able to go home. And the awakened walking ICU that I come from started basically doing what your team is doing this is back in the 90s, when they didn’t have oil tax, they were just starting to experiment with keeping patients with ARDS alive.

I mean, they were they really didn’t know what they were doing. And so they started a respiratory ICU. But it was essentially kind of like what you’re talking about a step down and took the patients that could not win from the ventilator from the shock trauma ICU, and then rehabilitated them.

And that’s what taught them how to do this Awake and Walking ICU approach, because they saw how hard it was how much work it was to rehabilitate these patients, and to actually get them off the ventilator, that when their outcomes were so good, like yours, our physician started saying, “Well, why don’t we send patients directly to that ICU from the ER?”

And that’s when they had the opportunity to do it right from the very beginning. But it was it was understanding that back end that inspire them to change the front end of critical illness. And that’s why I’m so excited to talk to you guys really about what you’re doing.

Because those of us on the ICU side have so much to learn from what you’re doing because your patients are still very sick. A lot of times our ICUs can’t get your kind of patients out of the ICU because l techs are full. But the ICU, don’t know, and don’t have the resources to rehabilitate them like you are. So how did you start building this kind of team and process?

Sam Nimah 7:48
Well, as Phillip said that the company’s you know, 31, 32 years old now. And it was started by a respiratory therapist, and a patient who had been in a coma and was trading on the ventilator. Okay? and when, when he came out of the coma, they didn’t know what to do with them. So that’s that was the crux of the founders of this company. Now Philip and I got involved back in 2014. And to say that we’ve, we’ve kept the feel and the touch of the original founding owners, but we’re only weaning at 80% of the time. And now we’re up to 86% of the time. And we’re not stopping. We continue to innovate, because we want to get to 100.

Phillip Morris 8:35
You know, Kali, earlier we’ve talked about this before, offline. Early mobility is such a huge key for these patients. And hospitals have you know, they’re in I understand this, they’re under the gun to staff efficiently throughout their hospitals. So as you know, most any large teaching hospital or even medium sized hospital for that matter, if you stop a respiratory therapist or a member of the rehab team in the hallway and ask them what their patient looks like that particular day, it’s going to be probably north of 15, maybe more, maybe a little less.

But the point is, is they’ve got a lot of patients, they’ve got to see each day. So if Miss Smith is in the ICU, on a ventilator with a lot of things going on, or that patient may be down MRI or CAT scan or off the unit for some reason. Well, that that that clinicians got to move on. They have other patients they’ve got to see.

So Miss Smith may or may not get therapy that day. It’s not the hospital’s fault. It’s just the way it is. And so we recognize that and so we want to get these patients out of that ICU as quickly as we can. We don’t operate ICU so the patients do have to be off vasopressors they do have to be off continuous sedation, which you’d have talked about that before as well as far as the getting them off the continuous sedation quickly, but getting them into our unit as quickly as possible so that we avoid those gaps in care.

By having a dedicated unit that is staffed strictly for that unit. In other words, these patients, excuse me, these clinicians do not get pulled to other units. Then if therapy comes to that room, and Mr. Smith happens to be an MRI that day, or has something else going on, guess what, they could come back later and do that same therapy.

So we’re able to provide therapies throughout the day, many times, multiple times a day. And by the fact that we allow our clinicians to really work the full scope of their education and training, you know, we’re not judging them and or not judging, we’re not watching how much they build per day, or how many units they build per day, the results are bad, or their success is based on the overall outcome of the patient.

And by having these clinicians work together in such a collaborative fashion, you know, each and every day, respiratory therapy, working hand in glove with PT, and OT, and nursing, so many things that are just regular activities of daily living, like under the toilet, or bathing becomes a therapy opportunity for these for these patients. And our therapists are right there ready to jump in and work with respiratory therapy and nursing to do these types of things.

So that’s just one aspect of our quote unquote, “secret sauce”. But I think it’s very important, though, to have a dedicated team allocated to this particular unit. And that’s just typically not in a hospital’s wheelhouse to do that. So we bring a very unique way of thinking and a unique way of staffing you know, to the hospital.

Sam Nimah 11:40
Kali, Phillip brings up, he brings up a great point about the rehabilitation opportunities, you know, in order for a patient to qualify for inpatient rehabilitation, they have to be able to tolerate three hours of therapy a day, right? But we also know in the acute setting, they can’t bill for anywhere close to that. Right? So how are you going to get a patient from one to three hours when you can only build for, you know, some limited amount of time, up to maybe an hour a day?

Well, by having our team dedicated to the unit, and more importantly, by allowing them to be measured by outcomes and outcomes only. We get to turn every patient interaction into a rehabilitation opportunity. As Phillip said, patient rings the nurse call button. Now, maybe they’ve already had therapy for the day, they ring the call button, I need to use the bedside commode. Fantastic. Let’s get OT in here. And we turn that into a rehabilitation opportunity. every chance we get. That’s how you get them to qualify for three hours.

Kali Dayton 12:49
And I’m just I just think this is the model that I see you should be following as well. And the barrier to doing that. They always say, well, we don’t have the resources. We don’t have the funding. We can’t afford it. But you’re kind of dispelling that you’re just proving that right. Tell us about the financial picture that’s you have. You don’t care about the PTs, OTs, billable hours, right, like you’re not going by each session. So how can you afford to do this?

Sam Nimah 13:20
So So here’s the phallus. Right. A hospital has a making it up 40 people on their rehabilitation staff or 60, respiratory therapists or 10, respiratory therapists, they have to meet the needs of an entire hospital. Okay. And we respect that. And we know, particularly in health care, there has been incredible staffing shortages, especially since the pandemic.

So, when you have needs all over the hospital, it’s very difficult to dedicate staff to a particular unit unless you outsource it to professionals like us who know what they’re doing. Okay. And now, we’re staffing it. So if you have a need somewhere else in the hospital, guess what? You can’t pull our staff because it’s a completely different company. All right.

So that’s kind of the magic of how we are able to dedicate the staff, a hospital can say they’re dedicating a staff, they can, they can try. They can try to But inevitably, there will be a staffing shortage in some discipline, and that they will have to pull from from what would be their respiratory care unit.

Kali Dayton 14:39
One study from a cvicu that’s now in a walking awakened walk into cvicu. They took their PT OT, staffing, therapists that were dedicated solely to their unit from two to four clinicians, and they decreased time the ICU I’m gonna say by 3.6 days.

Sam Nimah 14:59
That doesn’t Surprise me.

Phillip Morris 15:00
Sure.

Kali Dayton 15:02
We know that repeated studies show that poor care is expensive care. So what are the cost savings that you’re you’re providing for hospitals by doing it right?

Sam Nimah 15:14
Well, so we don’t get a full financial look at what we’re saving our hospitals. However, the Tampa General Hospital actually reported in an article not too long ago, that we saved them over $2 million in a fiscal year, as well as UAB Hospital in Birmingham, Alabama, documented that we saved them nearly 15,000 icu days, and just over five years. It’s easy math, though, that’s millions and millions dollars.

Kali Dayton 15:48
When you’re decreasing readmissions that severely you’re able to get them out of ICU sooner. I mean, I told you when I met you that my mission was to run you out of business.

Sam Nimah 15:59
Yes. And I encouraged you to do it. I love galley. I hope that someday, the world doesn’t need us, frankly.

Kali Dayton 16:09
Well, I think there, there will always be a need for rehabilitation, right, you’re always going to have the exception in which patients have to be sedated and immobilized. And they do get deconditioned. And they need rehabilitation. Right now, we have a process of care on the front end in the ICU in which we set most patients up to become that patient. And that’s why you’re so needed right now. But if we took note from what you’re doing, and transfer that into the front end, if we did it right the first time, how would that impact the volume and the kind of patients that you receive?

Sam Nimah 16:43
Well, look, like I said, I would love to see a situation where the world doesn’t need us, okay. Inevitably, if you if you really, truly got early mobility happening in the ICU, and we and we were able to perform the way we do in the tribe, in health care units in the ICU, I think you’d see a dramatic reduction in length of stay, you’d see a dramatic reduction in readmission rates, and you would see in a dramatic improvement in the ability for hospitals to wean patients from the ventilator,

Phillip Morris 17:21
you know, coming from an ICU background, you know, I understand the need for the ICU, the various types of ICUs for these types of patients and they’re high touch and for these unstable patients, then that’s you know, that’s where the hospitals certainly justify, you know, the the high touch model the two to one and whatnot.

Some have dedicated respiratory therapists, some don’t, I don’t know too many that have dedicated full rehab, you know, staffs within the ICU. But you know, the thing is, is that we need these ICUs there for those patients who truly need ICU and the intensivist, I think would would agree, but then we need to get them out of there. We don’t, that’s the highest rent district of a hospital.

So the hospital is patients don’t need to hang out there at day longer than they need to. So the function of the ICU is just that get these patients stabilized. And then let’s get them out. Let’s move them along the continuum and create this space. In your in your case, it’s the walking the the working, walking the ICUs. The, you know, for us, it’s for those ventilator patients that you’re talking to you for your units, that would be a myriad of patients, not just the ventilator patients, you would have other patients as well.

We are laser focused on the trach vented patient that gets you know, that’s already been identified as prolonged mechanical ventilation, they get trained, and then all of a sudden the fatigue factor sets in because all the clinicians, physicians, intensivist. Nursing, they’ve all decided, okay, well, we’re going to be known for the long haul illness, let’s transfer out to LTACH .

And that’s where we’ve got to change behavior and prevents hospitals that you’re doing the patients that don’t like doing them harm, but you’re really not doing what’s in the best interest, as opposed to creating a place in the acute care space to take care of these patients. And payers need to be understand this too. You know, that’s one of the things that we are keenly aware, payers need to understand the importance of this because we hear more times than not from a hospital,

“Well, the payers don’t want to pay to keep them in the ICU, you know, in the acute care setting.” But just like I said before, it’s in the long term best interest of not just the patients and their families, but also the payers and the hospitals to create units like we’re talking about because it does save everyone money payers hospitals, from a financial side to yield the improvement in clinical outcomes for the patient and the families.

Kali Dayton 19:57
I feel like if the payers Medicare, Medicaid, insurance agencies. If they really understood delirium, and ICU acquired weakness, this whole billing model would change, everything would change, they would really start. I mean, we’d have laws change. So there’s actual accounting for ventilator associated pneumonia. And they would see it acquired weakness as a avoidable hospital complication, just like a CAUTI or a CLABSI.

They would, just been the financial aspect of it, they’d be very interested, very invested and very involved. It feels like they’re pretty unaware. It’s almost like well, they throw in the ICU, they were on a ventilator, it’s unavoidable. They’re gonna have to be on the ventilator for weeks or months. And it’s gonna be an extensive rehabilitation process. And that’s just the way it is.

Sam Nimah 20:45
Yeah, Kali, let me tell you something, I get really upset when I hear about ventilator acquired pneumonia. That is acceptable. If, if the minimal care of a patient is taken there, you should never have we’ve been in business for over 30 years, we have never had a ventilator acquired pneumonia. It is ridiculous to see that happening.

Kali Dayton 21:09
Because your patients are up there mobilized. You don’t have the ln supine, sedated, unable to cough and able to protect your airways like you the second they come in your doors that’s over there up there mobilize. They’re just all the precautions are taken. Right. But I see a side will say well, you have better staffing. So if we were to say, to provide that kind of protective care, what’s the kind of staffing what what do we need to make that happen on the ICU side?

Sam Nimah 21:38
Yeah. Kelly, let me let me take a step back, because I think it’s it’s not better staffing. It’s the right staffing in the right environment, right. ICUs? In my opinion, are there intensive care to keep a patient alive and get them stable?

Okay, I think once they get stable, that’s when keep in mind, Phil. Phil mentioned earlier, these are traped vented patients that we care for. Not every patient in a NICU or a cvicu or a trauma ICU are traits invented, right? That’s where those patients getting consolidated into unit like ours once they’re hemodynamically, stable, right? Which is should be the intention of the ICU getting them stable. Once they’re stable.

This is where if we staffed every ICU, the way we staff, the the Trivent care units, I think it would be inefficient. Okay? But our ability to consolidate these patients into one stepdown level of care, right from ICU, and put the staffing there, we think it’s a pretty efficient model. So, you know, I love the work that you’re doing with getting the patients mobile early and moving. Obviously, not every patient can do that. Okay, and so this the multiple comorbidities, super medically complex patients that we care for those are those sort of anomalies on every ICU.

Kali Dayton 23:17
Do you see that the environment and almost like, the sign on the door impacts the care? So if someone’s in the ICU, and they really are stable, but they’re in the ICU, and they’re intubated, that almost blinds our clinicians to really looking at the big picture and saying, “Why are they sedated? Why are they still intubated? Why can’t they mobilize?”

Because it’s like, “well, they’re in the ICU, they’re in an ICU bed.” There’s a different mentality that comes with that. Whereas when they’re in your doors, “welcome to our Trivent unit, the expectation is you’re going to mobilize.” So having a different environment, I could see there being a benefit, I also feel like we can prevent a lot of tricky ostomies by mobilizing patients early on.

So I think ICUs need to be aware of this is one thing, I’m trying to train them as to how those skills to critically think, “Are they really that critical? Can they really not mobilize? Do we really need sedation? Do we really need these things?” but I see with the benefit of the environment where it’s like, “This is just what we do here, every patient is going to be up and moving to the best of their ability.”

Whereas in the ICU, we really have to triage and critically think through each patient because their status changes each day and sometimes throughout the day. So there is another layer of complexity in that.

Phillip Morris 24:37
It’s interesting to as we traveled around to see the different thresholds that various hospitals have with regards to tracking a patient. You know, you’ll see some hospitals where a patient may be having at two for 14 days. I mean, that’s almost unheard of, but for 14 days and others, you know, you don’t want to be still too long because they’ll trick you. They might take you in six or seven days, you know but it’s interesting to kind of see that,

Kali Dayton 25:02
Well, we see in these tracheostomy studies that early trachs have better outcomes. But I invite people to zoom out and look at: why is that? Is it really the whole in the neck? Because that’s not benign. That’s scar is a daily reminder to survivors of what they’ve been through. It comes with all sorts of other complications.

But is improved outcome because of the tracheotomy? Or is it because that’s when we finally take sedation off and get them moving? So I tell sometimes, these families: if that’s the only way that your loved one is going to get the sedation off and move. If the team will only do that. If they’re trait, then you better trach them ASAP. But if you can mobilize them beforehand to get them strong enough to successfully extubate that’s far better than even an early trach.

Sam Nimah 25:50
That’s ShangriLa, we should all stress that. Right?

Kali Dayton 25:52
Absolutely. But with they’re trach’d they better go to you. Because sometimes they go, they get tricked, and they go somewhere else to park in a very understaffed, poorly focused facility where they’re not going to get the same kind of care, they’re not going to actually get rehab rehabilitation they need and they end up back in the ICU.

And so it’s just as expensive circle of death, that continues to burden our system. So if our hospitals really are understaffed, during the financial crisis, whatever, it doesn’t make sense to continue what we’re doing. And by providing that kind of care, we decrease the the actual healthcare costs that patients are accruing. I also wanted to know about your staff themselves. So we talked about where we lost a lot of staff during the pandemic, after pandemic, there’s lots of turnover inside the hospital. But what’s happening on your units?

Sam Nimah 26:47
Yeah, you know, during the pandemic, we we heard, everybody was losing respiratory therapists and whatnot, we lost two PRN staff. That was it, all of our full time staff stayed. And I genuinely believe it’s because they get to work through the entire scope of professional training, they get to come to work and see a patient who comes in usually in really bad shape, and they get to walk out. You know, it’s that kind of satisfaction that that a few bucks down the road just can’t by you.

Phillip Morris 27:21
I agree, you know, we have in the past. And I know Sam can attest to this when interviewing for a new unit. We have had in the past, nurses, for instance, that have worked in the oil tech environment, and just telling them about our model and how it works. And what the ratios are. They literally shed tears of joy that they they’re going to be a part of a team that actually does what it says it’s going to do.

And the respiratory therapists are the same way they’re able to, you know, I’ve spoken to many respiratory therapists that they just feel like a technician. They’re like, we have so many patients to see each day, we go in, we tweak the ventilator, and we’ve got to get on to the next patient. So the ability to see the patient come directly from the ICU with multiple comorbidities, many times not even coherent or comatose, and to see them walk out or at least go out.

So significantly better, to the inpatient rehabilitation unit to see the fruition of their work is just so rewarding. And I think to be able to allow them to really spread their wings, as we said before fully work through the scope of their training and education. I think it just provides a rewarding experience that helps us with regards to recruiting and turnover.

Kali Dayton 28:49
That is so powerful, and really supports what I’m seeing with teams that I’m training. They go in there initially and they’re burnt out, they’re incredulous to what I’m explaining. They’re not sure about it. And they, it just the whole unit feels fragmented. And they’ve had high turnover. And this is something I hope we study later on is how the A to F bundle how humanizing our process of care improving outcomes impacts the turnover of staff that I’ve heard from clinicians,

“I was just about to leave critical care. I was so tired of working so hard, I felt so alone, and my patients were not surviving or having poor outcomes. I didn’t feel like I was doing anything. So why suffer?” to “I feel supported by my colleagues who are working collaboratively. I’m connecting with my patients, I feel fulfilled, I see them walk out the doors. I feel like I’ve actually made an impact and everything is easier and better.”

And so right now and during this crisis for so many reasons for the patients, for the hospital, for the clinicians, we can’t afford to continue to put patients into this death trap, essentially, because we’re not going to be able to retain our clinicians when they never get to be fulfilled. in their careers, because they’re working hard, what they’re doing is not the easy way. So they didn’t mobilize some patients is not easy. But as you can appreciate, rehabilitating them is not easy either. So prehabilitation them is still work, but it’s an effective work. It’s actually working for the patient.

Phillip Morris 30:18
Yeah. You know, it’s in the discharge process. And again, as a nurse, I can relate to this, working in a very high stress intensive care unit level one trauma center, and step down, and it’s done that as well. And you get these patients that are discharged and moved along the continuum. And, you know, you see the relief and a lot of the clinicians eyes, “Oh, thank goodness, they’re there. They’re moving on, they’re doing well.”

But what is amazing, and what is so cool are our units is that we have a graduation ceremony for our patients that move on to inpatient rehabilitation or home 26.7, there’s 27% of our patients go home. And that’s a huge number, considering the high acuity of the patients that come into our unit. But regardless, when they are winked from the ventilator and maintenance, the cannulated, and discharged off the unit, either to home, SNF, wherever they’re going, there’s a big to do, and our staff just get so excited about that.

And that’s one of the big things I have seen so many tears shed with just the clinicians as well as the patients when they’re moving along. And it’s true joy, to see this patient that has done so well over the last few weeks or whatever, to actually get their life back and move on. And then the patients of course, they come back many times to visit their staff and or to visit our staff. But no, I think that is a huge difference.

And just the whole mindset of our patients and excuse me of our staff, and the excitement and the fact that gets so much involved. So involved in the graduation ceremony with music and when paid to play the Rocky theme, where they’re being walking out or they be wheeled out. And it’s just, it’s just I would encourage anyone to be part of something like that, because it really is so gratifying. And so moving.

Kali Dayton 32:08
At the celebration of the team as well, I mean, they’re celebrating the patient and their success, but they’re also the team kind of gets to pat themselves on the back to say we did it too, we made this happen. We work together, we put forth so much effort and it was worth it. That’s what we’re really deprived of in the ICU we get, don’t always get to see that it was worth it.

And especially when they come back. It’s demoralizing. And I think clinicians know that when they send them out to LTACH. It’s not always a big celebration, it’s not always the best situation that they’re sending them to, but they don’t know what else to do with them.

Sam Nimah 32:43
Yeah.

Kali Dayton 32:45
What else would you share with the ICU community? And how can hospitals bring Trivent into their hospital?

Sam Nimah 32:52
So I would say to the ICU community, I would say listen to Kali Dayton. First of all, you’re doing some incredible work out there. And we absolutely love and respect what you’re doing. For for those ICUs that, that can’t afford or don’t feel like they can afford to implement prehab and get all those things accomplished.

Or if you just you have such a huge patient population, particularly traped invented. We are the leading organization in the United States in liberating patients from the ventilator period. And we’re here to support you. You can go to try vent healthcare.com To learn more about us. Or you can look me up Sam NEMA or Philip Morris. I know Philip Morris is a horrible name when it comes to liberating patients from the ventilator. I tell I’ve tried to get Philip to change his name repeatedly. He refuses. But when when your name is Philip Morris, you better be good at getting patients off the ventilator. That’s right.

Kali Dayton 33:59
You’re such a testament to that to the validity and the efficacy of these interventions. Early mobility works. It saves lives. It decreases healthcare costs. It provides humanity and fulfillment for clinicians. It works in L tech. It works in rehabilitation centers, it works in try event level care, it works in the ICU.

And I think if all these level of care, were to engage more in these elements, we would fix a lot of our big health care problems. So thank you for everything that you’re doing for patients and for our systems. And I look forward to learning more from you when you guys have more data coming out. Keep us posted. We’re really interested to know.

Phillip Morris 34:41
Most definitely thank you.

Sam Nimah 34:43
Thank you so much, Kali

Transcribed by https://otter.ai

Citations

Johnson, J. K., Lohse, B., Bento, H. A., Noren, C. S., Marcus, R. L., & Tonna, J. E. (2019). Improving Outcomes for Critically Ill Cardiovascular Patients Through Increased Physical Therapy Staffing. Archives of physical medicine and rehabilitation, 100(2), 270–277.e1. https://doi.org/10.1016/j.apmr.2018.07.437

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