John R. Loehner, MD
Ventilator-dependent ("vented") patients are among the highest burdens on the healthcare system, with more complex medical issues, longer hospital stays, and fewer options for care upon discharge from the hospital. Montefiore Medical Center’s goal is to reduce the number of vented patients, and vented patients’ bed days, while providing them with the best possible care and treatment.
With an eye toward more effective management of vented patients, Dr. Vincent Pantone, an instructor and teaching hospitalist, reinstated "vent rounds". Twice a week, Dr. Pantone, respiratory therapy managers, teaching hospitalists, and nurse managers visit newly vented, newly admitted ventilator-dependent, and non-vented trach patients. Pantone's team identifies patients who could be weaned from the ventilators and oversees the weaning procedure, involving pulmonologists when appropriate to ensure proper management of these patients. Dr. Pantone serves as an advisor guiding the team, making recommendations for treating and managing long-stay patients, alerting social workers when necessary, and identifying patients to be reviewed by the long-stay case committee. These practices lend another layer of support for trach care and assistance with this patient population.
Goals of this initiative include clarifying and improving house staff and physician assistants' understanding of the process of weaning and trach care, and educating practitioners more proactively manage these patients and serve as a filter or proxy in identifying more complex cases.