By: Michael Dacey, M.D., Riverside Health President & CEO
Throughout my career as an intensivist, I’ve seen firsthand how investing in a robust critical care service line has a ripple effect across every area of care. Intensivists manage a hospital’s sickest patients, freeing up time for other specialties, like surgeons and primary care physicians, to concentrate on their areas of expertise. They serve as consultants on complex patient cases, ensuring comprehensive, high-quality care across all departments. A robust critical care program enhances patient outcomes and optimizes a hospital's efficiency and effectiveness.
This knowledge is what compelled me to invest in the long-term health of Riverside’s intensive care program at the height of the pandemic. I recruited Ehsun Mirza, MD, a trusted colleague for over two decades, to lead the program. His talent, dedication and ability to understand others’ perspectives is why I knew he was the right physician to strengthen our critical care program.
From the start, I gave Ehsun a clear mandate and the necessary funding and resources to build a pulmonary and critical care program that would make both of us proud. By recruiting a team of expert critical care and pulmonary physicians, he's done just that since joining us in 2021.
Today, our pulmonary and critical care service line saves more lives than ever. Our outpatient multi-disciplinary team is far outpacing national averages for early lung cancer diagnosis, which is key to more positive outcomes.
Breathing life into the pulmonary and critical care division
When Ehsun arrived at Riverside, the pulmonologists were rotating between ICU coverage, inpatient pulmonary consults, pulmonary procedures and outpatient pulmonology practices. The increase of pulmonary and critical care patients during the pandemic and reliance on locums led to a significant backlog of outpatient pulmonology visits.
Ehsun significantly increased our bench strength by recruiting top talent from across the country –– a decision that’s had a transformative ripple effect across the health system.
We recruited additional expert physicians and advanced practice providers (APPs) to the core team, covering all areas of pulmonary care at Riverside Regional Medical Center, Riverside Doctors' Hospital Williamsburg, Riverside Shore Memorial Hospital and in January 2025, Riverside Walter Reed Hospital.
Recruiting top talent
Our expanded critical care team includes exceptionally trained, talented physicians dedicated to patient care. Starting in the pandemic, we began a five-year plan to build up our pulmonary care division, including intensivists for critical care, inpatient and outpatient pulmonologists, advanced bronchoscopy suite and sleep medicine physicians.
Today, the program includes 12 intensive care physicians in addition to outpatient pulmonologists, sleep specialists and several allied providers who can accommodate every patient. We continue to recruit more staff as our services expand.
Through focused recruitment, we developed a strong, dedicated critical care medical staff to lead the ICU care. This also freed up clinicians who had been covering the ICUs to focus on their other inpatient and outpatient responsibilities, reducing wait time and improving both patient outcomes and patient satisfaction.
Today, there isn’t a backlog of patients waiting for outpatient pulmonary care. In 2023, 90% of surveyed patients who visited Riverside pulmonary practices said they would highly recommend the practice to others in their community. Additionally, the focus on building specialty clinics and working collaboratively with other specialties has led to notable clinical achievements.
Intensive care unit saves more lives
With a more robust team, we’ve brought new life-saving treatment options to our ICUs.
For example, the team developed a pulmonary embolism response team (PERT) for patients whose extremity blood clots progress to their lungs –– a complication that’s often fatal without early intervention. Thanks to PERT, there’s been a dramatic decline in the death rate from in-hospital pulmonary embolism. Patients receive clot-dissolving medications quickly and if needed, interventional radiologists and vascular surgeons quickly intervene to remove the clot from the lung and resuscitate the patient.
New outpatient specialty pulmonary care clinics and catching lung cancer earlier
A larger medical staff made it possible to open specialty pulmonary clinics focusing on specific outpatient diagnostics and care. These include an asthma clinic, an interstitial lung disease (ILD) clinic, a lung nodule clinic and a sarcoidosis clinic.
I am extremely proud of the new lung nodule clinic, which creates a rapid pathway from identifying a concerning nodule through a rapid diagnosis process. With primary care, pulmonology, thoracic surgeons, radiology and oncology all collaborating, the program has been tremendously successful.
This diagnosis process is helped by our new, state-of-the-art, multi-million dollar bronchoscopy suite, which includes the only robotic navigational bronchoscopy in the region. This, combined with our lung cancer screening program using low-dose CT, allows for earlier detection of lung cancer, which continues to be the leading cause of cancer deaths in both men and women. This new bronchoscopy technology allows us to biopsy lung nodules we could only observe previously once they grew. Now, we catch nodules so small that our outpatient pulmonary care unit has seen the number of late-stage diagnoses for lung cancer go down, while early-stage diagnoses have gone up. Early detection of lung cancer is lifesaving and potentially curative.
With a refined clinical pathway, expert physicians collaborating across specialties, low-dose CT scans and new bronchoscopy technology, 63% of Riverside’s lung cancer diagnoses are currently caught at an early stage, far exceeding the national rate. This earlier diagnosis allows for earlier treatment and improved patient outcomes.
| Lung Cancers Diagnosed | 2020 | 2021 | 2022 | 2023 |
| Early Stage | 39% | 50% | 59% | 63% |
| Late Stage | 61% | 50% | 41% | 38% |
What’s next for critical care at Riverside
This fall, we’ll begin having 24/7 on-site critical care physician coverage in the Riverside Regional Medical Center ICU 365 days a year. The critical care program at Riverside will continue to grow to support the increasing complexity of tertiary care patients.
Additionally, one or two clinically licensed advanced practice providers will train with our intensive care medicine program through the new Riverside APP Critical Care Fellowship Program, where they’ll gain training seldom offered to these allied providers who are crucial to our ability to support patients.
Critical care is rapidly evolving, driven by innovative technologies that enhance survival rates for severely ill patients and the increase in individuals requiring intensive care. Meanwhile, early detection is giving patients more treatment options and better outcomes.
At Riverside, we will continue to expand and advance our critical care program and outpatient pulmonology services to meet these growing needs and provide the highest level of care for our patients.