Staff acceptance of a telemedicine intensive care unit program: A qualitative study

Moeckli, Jane; Cram, Peter; Cunningham, Cassie; Reisinger, Heather Schacht

doi:10.1016/j.jcrc.2013.05.008

Cited by 88 publications

(40 citation statements)

References 20 publications

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“…For patient‐centred care to become truly embedded in an organization and in the broader healthcare system, it must be dependent on reliable systems, rather than the behaviour of individuals. Eisenberg alleged that “medicine is social in nature and this is more applicable inside a hospital.” Organizational and teamwork factors have profound impact on quality and care outcomes, particularly in the ICU where organizational and teamwork factors are central to daily operations (Moeckli, Cram, Cunningham, & reisinger, ; Weled et al, ; Young, Chan, & Cram, ).…”

Section: Discussionmentioning

confidence: 99%

“…Eisenberg alleged that "medicine is social in nature and this is more applicable inside a hospital." Organizational and teamwork factors have profound impact on quality and care outcomes, particularly in the ICU where organizational and teamwork factors are central to daily operations (Moeckli, Cram, Cunningham, & reisinger, 2013;Weled et al, 2015;Young, Chan, & Cram, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Barriers to patient and family‐centred care in adult intensive care units: A systematic review

2019

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Aim Despite remarkable theoretical evidence of positive outcomes of patient and family‐centred care, it is rarely performed in the intensive care setting. The aim of this review was to assess the barriers to patient and family‐centred care among healthcare providers, patients and family members in adult intensive care units. Design A systematic review of both qualitative and quantitative studies. Methods The search strategy sought for published peer‐reviewed research papers limited to English language from conception to 2018. The review protocol was registered in the CRD Prospero database (CRD42018086838). Literature search was carried out in four databases: EMBASE, Cochrane Library, PubMed and Scopus where keywords “barriers,” “patient and family centered care,” “patient‐centered care” and “intensive care unit” appeared in any part of the reference. Hand search of reference lists of identified papers was also done to capture all pertinent materials. Each study was assessed by three independent reviewers against the inclusion criteria. Evidence was graded according to sampling quality, quantity and measurement of intended outcomes. Screening of studies and citations resulted in seven studies that were included in the analysis. Results Barriers to patient and family‐centred care broadly fall under four categories; lack of understanding of what is needed to achieve patient and family‐centred care, organizational barriers, individual barriers and interdisciplinary barriers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Barriers to patient and family‐centred care in adult intensive care units: A systematic review

2019

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“…32 Additionally, large urban hospitals may staff the ICU telemedicine unit with nurses and physicians that also work in the target ICUs, engendering trust and improving communication between the telemedicine and bedside clinicians. 33 Yet much of this heterogeneity remains unexplained. More research is needed to understand variation in program effectiveness and develop strategies to improve quality in existing programs and optimize impact in new programs.…”

Section: Discussionmentioning

confidence: 99%

ICU Telemedicine and Critical Care Mortality

Kahn

Barnato

et al. 2016

Medical Care

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Background Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. Objectives To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. Research design We performed a multi-center retrospective case-control study using 2001–2010 Medicare claims data linked to a national survey identifying United States hospitals adopting ICU telemedicine. We matched each adopting hospital (cases) to up to 3 non-adopting hospitals (controls) based on size, case-mix and geographic proximity during the year of adoption. Using ICU admissions from 2 years before and after the adoption date, we compared outcomes between case and control hospitals using a difference-in-differences approach. Results 132 adopting case hospitals were matched to 389 similar non-adopting control hospitals. The pre- and post-adoption unadjusted 90-day mortality was similar in both case hospitals (24.0% vs. 24.3%, p=0.07) and control hospitals (23.5% vs. 23.7%, p<0.01). In the difference-in-differences analysis, ICU telemedicine adoption was associated with a small relative reduction in 90-day mortality (ratio of odds ratios: 0.96, 95% CI = 0.95–0.98, p<0.001). However, there was wide variation in the ICU telemedicine effect across individual hospitals (median ratio of odds ratios: 1.01; interquartile range 0.85–1.12; range 0.45–2.54). Only 16 case hospitals (12.2%) experienced statistically significant mortality reductions post-adoption. Hospitals with a significant mortality reduction were more likely to have large annual admission volumes (p<0.001) and be located in urban areas (p=0.04) compared to other hospitals. Conclusions Although ICU telemedicine adoption resulted in a small relative overall mortality reduction, there was heterogeneity in effect across adopting hospitals, with large-volume urban hospitals experiencing the greatest mortality reductions.

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“…Two reported perceptions in anticipation of tele-ICU, 9,10 and two reported on perceptions of hub facility personnel only 11,12 ; the remaining four reported on staff perceptions in hospitals receiving the service. [13][14][15][16] One analyzed interview data, 15 and the other three provided limited information on brief surveys that were collected from a small number of staff. 13,14,16 Generally, these studies reported user satisfaction with the technology, effect on receiving care locally, quality of care, and overall tele-ICU use.…”

Section: Discussionmentioning

confidence: 99%