Home to the first pediatric Cardiac Intensive Care Unit (CICU) in the Southeast, the Nicklaus Children's Hospital Heart Institute has long been at the forefront of pediatric cardiology and cardiovascular surgery.

In 2016, the hospital relocated its CICU to the hospital's Advanced Pediatric Care Pavilion to advance care options for infants and children. In addition to featuring leading-edge technologies, a key element of this new CICU was designing the environment to support innovative multidisciplinary care. Today, the cardiology, cardiovascular surgery and CICU teams within the Heart Institute continue to lead the way with the implementation of an acuity-adaptable model of care.

Pediatric CICU patients, their families and their healthcare teams face unique challenges at all points of care, including when patients are ready for a step down in acuity. The acuity-adaptable model of care affords the opportunities and resources necessary to provide exceptional patient care while decreasing cost, improving patient and staff experience, and increasing patient safety.

The complexity of our patients is extremely high, which lends itself to having a multidisciplinary team approach to care. In the field of cardiovascular surgery, we are addressing more complex issues than we used to, which requires collaboration between clinical teams. The acuity-adaptable model supports that collaboration.

Creating a Hospital Within a Hospital

Utilized by few pediatric cardiac care centers in the U.S., the acuity-adaptable model of care approach enables patients at all acuity levels to stay in the same room from admission to discharge. Each room is thoughtfully designed to allow for adaptation and smooth transitions between clinicians, treatments and technologies as patients' needs change.

Additionally, this model, commonly referred to as patient- and family-centered care, encourages communication, improved continuity of care and partnerships between cardiologists, cardiovascular surgeons, CICU specialists and nursing staff.

Consistent Support for Pediatric Cardiac Patients and Their Families

While CICU and acute cardiology team members are better able to shift care with the use of the acuity-adaptable model, pediatric patients and families typically experience increased feelings of safety and stability and the ability to develop stronger relationships with nurses and other staff. Fewer transitions, lower stress levels and stronger relationships with the care team allow patients and families to focus on comfort and healing, often contributing to improved outcomes.

In the acuity-adaptable model, the largest difference for the patient and their family is that the attending physician changes from a person who's dual trained in cardiology and CICU care to a cardiologist. From a patient satisfaction standpoint, the acuity-adaptable model gets very high scores because the families are the focal point of the care setting. They get to stay in the same room and have the same rotation of nurses. Many things remain stable.

Designed for Safe, Efficient Multidisciplinary Care

As much as the model improves care and outcomes for patients and families, team members also benefit from improved professional collaboration.

The acuity-adaptable model of care means the CICU team is going to be physically close to other cardiac care team members. People who work in cardiac institutes or heart centers like what they do. They like being steeped in cardiac care. When the CICU and the step-down unit are on the floor together, everybody is in the same boat. It gives the team a more immersive professional experience.

An acuity-adaptable model requires an intentionally designed hospital environment, which adds value for everyone involved in patient care. Benefits include:

• Consolidating expertise, equipment and supplies, creating improved efficiencies
• Decreasing intra-hospital patient transfers
• Improving the organization of team members on the unit
• Increasing patient safety
• Saving cost and time often lost during traditional unit transfers
• Supporting continuity of care