Baptist Health Care Celebrates a New State-of-the-Art Hospital and Acute Dialysis Program
Summary
This northwestern Florida health system has given its dialysis and ICU nurses control over acute dialysis services and the ability to expand their program, after converting from an outsourced provider and moving to a large and modern new facility.
In the aftermath of the COVID-19 pandemic in early 2023, operational pressures prompted the Baptist Health Care system to look at new and innovative ways of providing patients with the highest level of care. One significant cost center was outsourced dialysis services, and expenses had been rising due to increased demand for dialysis in the network’s northwestern Florida and southern Alabama region.
Clinical healthcare leader Michael Rauch, MBA, RN, NE-BC, Executive Director of Emergency and Critical Care and ICU Director at Baptist Health Care, started examining alternatives to address this growing problem. He noticed online that a hospital where a colleague worked had recently gone live with an in-house acute dialysis program, utilizing the Tablo® Hemodialysis System. He reached out to his friend and learned about the facility’s successful transition away from contracted dialysis services to training its own staff to manage patients efficiently using clinically versatile Tablo. Based on this feedback, he decided to explore an outsourced to insourced conversion as an option for his hospital, Baptist Pensacola in Pensacola, FL.
“This level of empowerment resonated with us, because Baptist nurses have a different level of ownership in what we do,” says Rauch. “In our dialysis unit we take full ownership of the patient, so the floor nurses, who managed that patient initially, can focus on others.”
Rauch and his team worked with Baptist Health Care leadership and the Outset Medical team to analyze the overall costs and benefits of launching an in-house program, and based on the results, they made plans to transition away from the outsourced provider. Baptist Pensacola went live with its in-house acute dialysis program, using only Tablo machines, on May 1, 2023.
After Rauch and the nursing teams had about four months of experience with their program, it was time for a big move. In September, a new, state-of-the-art Baptist Hospital campus opened in Pensacola, where a modern new dialysis unit is accommodating a growing number of patients, thanks to the ease of training and use with Tablo. And, to address the need for critical care renal replacement, ICU nurses at the hospital are now also learning to become proficient with using Tablo.
Nursing Staff Teambuilding and Independence
Rauch says they have been very lucky with their in-house staffing, even prior to the initial Tablo go-live date. He and his team brought all the nurses together to learn about Tablo and team build. “We really wanted them to get to know and recognize each other. We really pushed that because for so long our dialysis had been outsourced. It’s been fun,” he says.
Rauch also says that efficiencies are much improved since bringing dialysis in-house with Tablo. “The biggest thing is I don’t have to go ask permission to do something,” he says. “If we need to make a change to a patient’s dialysis treatment, we make the change. I don’t have to deal with a third party, and them having to decide if our request is in the contract. We’re able to quickly pivot and make a lot more decisions on how our program works, versus the contractor telling us what they’re going to do.”
State-of-the Art New Hospital and Dialysis Unit
In September, Baptist Health Care opened the doors to its newly constructed Baptist Hospital campus (pictured at the top of this page), located about three miles from the original 72-year-old hospital site. Rauch says that moving the contents of an entire hospital and all the patients was no easy feat, but it was well planned and well executed. The new facility is in a much more accessible location, close to Interstate 110, and has been very busy.
The new hospital includes a large dialysis unit that Rauch and his team were heavily involved in designing, and a fleet of Tablo consoles.
“We had a lot of say in how the unit was set up and where we wanted it,” he says. “We decided to put it on the third floor, same as the ICU. That makes it easier for the teams to work together to take care of patients needing dialysis.”
Rauch says that the new unit has five open bays, one private room and lots of storage. The nurses have their own breakroom, which they never had before, with lockers and bathrooms. “Our old unit was like a big closet, we were beyond excited to move to the new hospital,” he says.
He says that about two months prior to the new campus opening, he and his team worked with Outset to make sure they had everything they needed. “Our nurses were constantly over at the new facility getting the whole dialysis unit, and the Tablo consoles and supplies ready. This really created a buzz and an excitement for the whole team. The machines were moved over on a Saturday and Sunday, so no treatments were missed. It’s been a very smooth process for us going live with Tablo, really since the beginning at our old facility, and our volumes have been growing.”
Rauch says they’re up to about 280 dialysis treatments a month, with 230 of those being intermittent hemodialysis (IHD) and 50 SLED (sustained low efficiency dialysis) treatments, along with some treatments for critically ill patients up to 24 hours in the ICU, using Tablo with the PRO+ upgrade*.
Pride and Satisfaction
Rauch notes that everyone has been very satisfied with Tablo, and having in-house control over their program.
“We own our own program now, and we’ve been able to decide how we staff,” he says. “That’s been huge. Our nurses set the machines up and take them down, and we’re able to order our own supplies. I don’t have to pay late fees now if I start a treatment late, so that’s a plus. Also, the physicians have been very cooperative, as they were familiar with Tablo before the switch. Our dialysis nurse manager, who started a month before we went live, had helped start a Tablo program near us previously, which has been invaluable. Patients like Tablo also, they have anecdotally commented how they like it so much better than our previous machines, and they don’t feel as worn out after treatment.”
Dialysis Expertise in the ICU
Rauch is currently focused on training nurses in the ICU to implement hemodialysis treatments on their patients.
“The most surprising impact out of this whole conversion was that the ICU nurses wanted to take on this new technology completely,” he says. “The dialysis nurses will still deliver the machine and hook the patient up, but with the ICU nurses initiating dialysis, the dialysis nurses will be able to focus on the patients in the dialysis treatment room,” he says. “We thought there may be some pushback from the ICU nurses, but they really wanted to do it. We got our ICU educator involved, and the nurses will be going through the Tablo Coordinator program.”
The Power of Communication, and Future Growth
Rauch offers his experienced perspective to others: “I would recommend Tablo to other hospitals considering an alternative to a third-party dialysis provider. The Outset team is an amazing asset. My advice is take your time, plan it out, get the support of your physicians, get the support of your CMO. You can’t overcommunicate what you’re doing. The biggest thing is everyone knew it was coming, we educated like crazy on it, and we got them used to it. It made a difference.”
Rauch says the health system is also looking at bringing Tablo in-house at a sister hospital seven miles across Pensacola Bay, the busy 55-bed Gulf Breeze Hospital, where he and his team would help with the program planning and launch. This growth, in response to the rising need for dialysis services in their community, helps fulfill Baptist Health Care’s aim to transform healthcare in its community, and help give patients the highest quality of life possible.
* PRO+ is an optional upgrade to Tablo that enables treatment duration greater than 12 hours and up to 24 hours and dialysate flow rate down to 50 mL/min.
About Baptist Health Care
Baptist Health Care is a not-for-profit health care organization based in Northwest Florida that is committed to helping people throughout life’s journey. Baptist continuously strives to be a national leader in quality and service. Baptist Health Care includes three hospitals, four medical parks, Andrews Institute for Orthopedics & Sports Medicine and a large network of primary care and specialty physicians. Baptist Health Care is one of the largest non-governmental employers in Northwest Florida.
Baptist Health Care • Baptist Hospital • Gulf Breeze Hospital • Jay Hospital • Baptist Medical Parks Airport, Nine Mile, Navarre and Pace • Andrews Institute • Baptist Medical Group • Baptist Heart & Vascular Institute • Baptist Health Care Foundation
Important Safety Information
Indication statement:
The Tablo® Hemodialysis System is indicated for use in patients with acute and/or chronic renal failure, with or without ultrafiltration, in an acute or chronic care facility. Treatments must be administered under physician’s prescription and observed by a trained individual who is considered competent in the use of the device. The Tablo Hemodialysis System is also indicated for use in the home. Treatment types available include Intermittent Hemodialysis (IHD), Sustained Low Efficiency Dialysis (SLED/ SLEDD), Prolonged Intermittent Renal Replacement Therapy (PIRRT), and Isolated Ultrafiltration.
Caution statement:
This device is not indicated for continuous renal replacement therapy (CRRT) and is cleared for use for up to 24 hours. The dialysate generated by this device is not sterile and should not be used for intravenous (IV) infusion.
Disclaimers:
For safety and effectiveness information, indications for use, risks, cautions and warnings, please refer to the product labeling for the Tablo Hemodialysis System.
The views and opinions expressed in this blog post represent the personal opinions of the facility staff. The content should not be taken as medical advice. Never ignore professional medical advice in seeking treatment because of content you have read on the Outset Medical website.
