Multidisciplinary Quality Review Process in a Telecritical Care Unit

Tuesday, March 24, 2026

11:15 AM - 12:15 PM Central Time

Location: Connections Central - RST 10

Carly Boger, BSN, RN, CCRN

North Carolina

Disclosure(s): No relevant financial relationship(s) to disclose.
NT

Nehal Thakkar, MD

Intensivist
Atrium Health

Disclosure information not submitted.
Marie Mercier, MSN, APRN, AGCNS-BC, NEA-BC (she/her/hers)

North Carolina

Disclosure(s): No relevant financial relationship(s) to disclose.
MR

Michael Reif, MD

Intensivist
Virtual Critical Care, Advocate Health

Disclosure information not submitted.
SM

Shannon Morris, MSN, APRN, ACCNS-AG, CCRN

RN Administrative Supervisor
Virtual Critical Care, Advocate Health

Disclosure information not submitted.
NH

Noelle Hartley, MSN, RN, CCRN-e, NEA-BC

Clinical Nurse Program Coordinator
Atrium Health Mint Hill Primary Care

Disclosure information not submitted.
CW

Christy Wilbanks, FNP-C, AGACNP-BC

Chief APP – AH Virtual Critical Care
Atrium Health

Disclosure information not submitted.
MG

Michal Glass, N/A

Director Medical Staff Quality
Atrium Health

Disclosure information not submitted.
ST

Sara Tucker, MBA, BSN, RN, CCRN

Senior Business Intelligence
Virtual Critical Care, Advocate Health

Disclosure information not submitted.
TM

Taylor Morris, N/A

taylor.morris@advocatehealth.org
Virtual Critical Care, Advocate Health

Disclosure information not submitted.
Erika L. Setliff, DNP, APRN, CCRN, ACNS-BC, FCCM

Atrium Health, North Carolina

Disclosure information not submitted.

Introduction: Event reporting improves quality of care and is considered beneficial when data is effectively collected and acted upon. This telecritical care unit, known as Virtual Critical Care (VCC) supports more than 200 ICU beds at 17 sites in the Southeast of the US, supporting patient care needs and emergencies with critical care expertise. The Quality Review Committee (QRC) is comprised of nurse, physician, and APP leaders along with the director of medical staff quality. VCC is strategically aligned with regional multidisciplinary practice and quality structures across a Critical Care Network within a health system.

Methods: Case Reports come through emails to leadership, concerns reported at VCC teammate huddles, formal risk event reporting, and a secure internal intake form that allows any member of the team to report an incident, practice observation, or concern. Members of the leadership do in-depth timeline and case review of all reported events. Structured multidisciplinary QRC meetings are used for case presentation and discussion, trending, and follow up to drive improvements in VCC workflows and accountability, facility trends, and regional improvements to policies, orders, and practice.

Results: Case review has increased dramatically the past few years through encouraging teammate reporting from 40 cases in 2022, to 136 and 267 cases in 2023 and 2024, respectively. In the first 6 months of 2025, there were 128 cases, consisting mostly of clinical practice (88), system opportunities (33) and communication (28). After review and discussion, action planning yielded follow-up with site leadership (37.8%) and medical directors (11.9%), trending (14.1%), performance improvement plans (11.11%), clinician feedback (7.4%), education (4.4%), and changes to duties, workflow, or supervision. There is system-level impact on EMR changes and policy/practice alignment to include missing code statuses, sedating medications remaining on the medication administration record after extubation, and standardization of medication availability at sites across the region.

Conclusions: Effective review of events with structured multidisciplinary action planning in a telecritical care unit drives quality and improves practices across a large critical care network.