A new intensive care unit model may help caregivers reduce the number of chronically ill patients sent to the ICU as a result of potentially preventable factors.
The Leadership, Ownership, Transformation, Unity and Sustainability, or LOTUS, model was developed by Rutgers University in New Brunswick, N.J., and West Orange, N.J.-based RWJBarnabas Health System. It is patient-focused and involves an ICU team composed of physicians, nurses, pharmacists, social workers and chaplains, as opposed to previous models where ICU physicians lead all the planning and did not take the patient perspective into account.
In the first year of using the LOTUS model, ICU caregivers were able identify the underlying causes of health issues that sent patients to the ICU. For example, the model helped caregivers assess patients who ended up in the ICU after failing to take diabetes or blood pressure medications.
"Under the LOTUS model, by focusing on the patient perspective we discovered that some patients had received confusing, mixed messages about the medicine from their healthcare providers. Other patients were struggling with financial or emotional problems that made self-care difficult," said Liza Barbarello Andrews, PharmD, lead researcher and a clinical associate professor at Rutgers' Ernest Mario School of Pharmacy in Piscataway, N.J., and critical care pharmacy specialist at Robert Wood Johnson University Hospital in New Brunswick.
Social workers on the ICU team were then able to help address those issues.
Researchers developed the model at Robert Wood Johnson University Hospital Hamilton (N.J.), after it merged with RWJBarnabas Health System in 2016. They detailed their findings in Creative Nursing.