Prior to 2025, ventilator-dependent patients across Eastern Health Cluster frequently experienced prolonged ICU and inpatient stays due to the absence of a structured pathway for safe home invasive mechanical ventilation (HIMV). This resulted in:
- Extended bed occupancy
- Increased exposure to hospital-acquired infections
- High readmission rates
- Escalating costs of care
- Reduced patient autonomy and quality of life
The HIMV Program was established as a system-level Value-Based Healthcare transformation, designed to deliver superior outcomes at lower total cost across the full respiratory care cycle.
The initiative is built on four strategic pillars:
1. Governance & Standardization
A cluster-wide policy framework (CAPP 361) and comprehensive operational manual ensure consistent implementation, risk mitigation, and clinical governance across facilities.
2. Integrated Multidisciplinary Model (Virtual IPU)
The program connects ICU physicians, pulmonologists, respiratory therapists (hospital and home), nursing teams, emergency medical services, biomedical engineering, and logistics into a coordinated care pathway spanning hospital-to-home transition.
3. Caregiver Empowerment & Safety Assurance
Each patient must have two trained caregivers who complete a structured two-week competency program prior to discharge. Home infrastructure assessments, emergency preparedness protocols, and ventilator trials in ICU are mandatory components.
4. Resource Optimization before Procurement
A cluster-wide equipment review identified 35 underutilized ventilators. Strategic reallocation avoided SAR 1,238,900 in capital expenditure and enabled rapid scale-up without new procurement.
Measured Impact (2025 Implementation ā Zones A, B, D)
- 50% reduction in 30-day hospital readmissions (40% ā ~20%)
- 50% reduction in average length of stay (30 days ā 15 days)
- 30ā40% reduction in total cost compared to inpatient ventilation
- Reduced ventilator-associated and hospital-acquired infections