Thomson Hospital Kota Damansara

Esther May Cheam Sue San

As the world revolutionizes towards artificial intelligence (AI), we are also witnessing the mushrooming of Environmental, Social and Governance (ESG) practices in every growing industry i.e. finance, manufacturing, agriculture, construction and the list continues on. While the healthcare sector has also stepped up with these advancements and grabbing every opportunity along the way for business expansions, it also benefits the management of patients especially in the critical care departments such as the Intensive Care Unit (ICU). 

Being an ICU nurse in this digital era and juggling with the accolades of ESG in hindsight really sounds like an impossible daunting task to accomplish. However, AI is already making its way to be ingrained in human lives and people accelerating on ESG routines gradually but surely. For healthcare professionals, especially in the nursing community, we do focus on the positive impact of what we do onto our patients. By harmonizing AI into critical care management, nurses will definitely be able to magnify the drives for ESG. For instance, having an ICU set up with fully AI automated in a healthcare facility would provide more time for critical care nurses to focus on patients’ needs as well as their quality of care. Thus, reducing extensive paperwork and vast carbon footprints. 

To improve on a net impact, healthcare industry must undergo numerous trainings in reducing waste, reducing energy consumption and develop initiatives which promote environmental responsibilities. Encouraging not only nurses, but also involving the patients to participate in the ESG initiatives inside the hospital itself would further enhance the awareness for the public and community.

There are also several ways to increase the operational efficiencies with new digital technologies being used in the ICU. Having an advanced monitoring system for a critically ill patient to detect not only deterioration but to pre-empt nurses on the risks of patient’s safety too. For instance, the fully automated smart medical beds are equipped with advanced alarm system to prevent patient from falling with other additional features like weighing scale and other interactive electronic components which is integrated into the Hospital Information System (HIS). This is slowly  dominating some financially established private hospital settings in Malaysia as the C suites view  such small yet important feature as a long-term investment versus the probable medico-legal risk  implications. It has also been viewed as a gold standard of treatment in places like New York as these smart beds can track anything, example pneumonia and bed ulcer prevention.

“The basic human touch in critical care is the ultimate need for any healthcare facility”

Gearing up an ICU exclusively with more advanced AI technologies would be every critical care nurses’ dreams and by doing so, nurses could be more focused on providing seamless quality nursing care and improving patient experiences throughout their stay in the hospital. Patient centred services should be well coordinated whilst utilizing AI in maximizing outcomes and reducing care costs. Key stakeholders will be more than appreciative of the transformation in patient engagement and extraction of essential information to meet the demands of this business in gaining financial returns with the support of patient-clinician relationship.

Depicting an article from PubMed Central® titled “Artificial intelligence in critical illness and its impact on patient care: a comprehensive review” published online in April recently, AI algorithms have been created for specific real-time data analytics in distinguishing and predicting disease  progressions which aids in complex decision-making thus offering personalised solutions to unique  patients respectively. 

A profound example is briefly noted in Vincent X. Liu’s paper on “The future of AI in critical care is  augmented, not artificial, intelligence” whereby normalizing the AI in healthcare nomenclature  would greatly secure positive results if engaging of these technologies equitably executed. Generally speaking, by executing a robust mechanism of AI application in the ICU, machine learning techniques must still be made as simple and user-friendly as possible which can never be cumbersome to use.

According to Society of Critical Care Medicine, annual critical care medicine costs increased 92%, from $56.6billion to $108billion. Intensive care unit (ICU) costs per day in the United States in 2010 were estimated to be $4300 per day, a 61% jump since the year 2000 cost per day of $2669. Echoing to this, a Malaysian teaching hospital required a longer length of ICU stay. This was based on a study done by Aung YN et.al in 2020 when they published in Value in Health Regional Issues. Longer ICU stay translates to higher mortality rates. Hence, implementations of strategies that can reduce the length of stay and hospital costs without compromising healthcare would be much applauded by stakeholders who look forward to generating wider profit margin. ESG strategies must be weaved into the organizations and should be part of the risk management assessment and strategy in enhancing reputations with patients, employees, investors, analyst as well as the public. A simple motion such as practising green building, going paperless and recycling wastes or reducing food wastes could easily decarbonize the healthcare sector, leading to decreasing greenhouse gas emissions. Being a responsible steward to our environment and with good data on hand, I believe many organizations will be able to tout on the key ESG initiatives in developing a more structured road map for future endeavours.

I have seen many ICUs in the country and the Middle East in my total 20 years of Nursing. With the bountiful growing initiatives of ESG and development of AI across the regions, there is immense room for improvement to be done in every ICUs and any healthcare facility around the world.  Significant changes can only be made when organizations increase ESG reporting and execute meaningful ESG strategies using the accurate tools with the architecture of AI aspirations to achieve maximum equipment usability. It will be pretty interesting sight to imagine if these efforts came true.