Contributions of tele–intensive care unit (Tele-ICU) technology to quality of care and patient safety☆,☆☆
Section snippets
Purpose
Tele-Intensive Care Unit (Tele-ICU) is a remote monitoring technology that promotes the efficient deployment of intensivists and other critical care resources [1], [2]. This technology can provide intensive care units (ICUs) with 24/7 access to intensivists and critical care nurses [2], [3] and help ICUs meet the Leapfrog Group's ICU Physician Staffing standard [4]. The Leapfrog Group suggests that quality of care in ICUs is strongly influenced by (1) whether intensivists are providing patient
Study design
This study was part of a larger National Science Foundation–funded study of tele-ICU nurses (http://cqpi.engr.wisc.edu/vicu_home). We conducted semistructured interviews with tele-ICU managers, physicians, and nurses to obtain rich in-context qualitative data about the potential contributions of tele-ICU technology to patient outcomes. We did not collect quantitative data because they were not relevant for our research's objective. Qualitative research is appropriate when relatively little is
Results
A total of 61 tele-ICU staff (10 managers, 15 physicians, and 36 nurses) from 5 tele-ICUs participated in the study. A total of 722 pieces of data were coded into 28 nodes describing contributions of the tele-ICU to care processes and outcomes (Table 3, Table 4). Six hundred thirteen comments were assigned to 19 nodes of positive contributions (Table 3), and 109 comments were assigned to 9 nodes of negative contributions (Table 4). Seven themes emerged from our analysis. Below, we describe the
Conclusions
In this study, we were able to identify contributions that the tele-ICU provided to critical care processes and outcomes. The tele-ICU managers, physicians, and nurses whom we interviewed discussed more positive tele-ICU contributions than negative contributions. Below, we discuss 5 pertinent findings about the contributions of tele-ICU.
Acknowledgments
We thank all tele-ICU staff for taking the time to participate in the study; this research was not possible without them. We also want to thank Dr Kenneth Wood for his assistance with the study and Christine G. Holzmueller, BLA, for her assistance in editing the manuscript.
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Institutions where work was performed: Five tele–intensive care units across the United States.
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Financial support: This research study was partly funded by the National Science Foundation (OCI-0838513; principal investigator: Pascale Carayon, PhD).