title: Perceived benefit of a telemedicine consultative service in a highly staffed intensive care unit.
abstract: OBJECTIVE
  The aim of this study was to evaluate whether a nocturnal telemedicine service improves culture, staff satisfaction, and perceptions of quality of care in a highly staffed university critical care system.
  
  
  METHODS
  We conducted an experiment to determine the effect of telemedicine on nursing-staff satisfaction and perceptions of the quality of care in an intensive care unit (ICU). We surveyed ICU nurses using a modified version of a previously validated tool before deployment and after a 2-month experimental program of tele-ICU. Nurses in another, similar ICU within the same hospital academic medical center served as concurrent controls for the survey responses.
  
  
  RESULTS
  Survey responses were measured using a 5-point Likert scale, and results were analyzed using paired t testing. Survey responses of the nurses in the intervention ICU (n = 27) improved significantly after implementation of the tele-ICU program in the relations and communication subscale (2.99 ± 1.13 pre vs 3.27 ± 1.27 post, P < .01), the psychological working conditions and burnout subscale (3.10 ± 1.10 pre vs 3.23 ± 1.11 post, P < .02), and the education subscale (3.52 ± 0.84 pre vs 3.76 ± 0.78 post, P < .03). In contrast, responses in the control ICU (n = 11) declined in the patient care and perceived effectiveness (3.94 ± 0.80 pre vs 3.48 ± 0.86 post, P < .01) and the education (3.95 ± 0.39 pre vs 3.50 ± 0.80 post, P < .05) subscales.
  
  
  CONCLUSIONS
  Telemedicine has the potential to improve staff satisfaction and communication in highly staffed ICUs.
authors.affiliation: Department of Anesthesiology, Johns Hopkins, University School of Medicine, Armstrong Institute for Patient Safety and Quality, MD, USA. mromig1@jhmi.edu
authors.forename: Mark C
authors.initials: MC
authors.lastname: Romig
authors.forename: Asad
authors.initials: A
authors.lastname: Latif
authors.forename: Randeep S
authors.initials: RS
authors.lastname: Gill
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.forename: Adam
authors.initials: A
authors.lastname: Sapirstein
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D015279:Organizational Culture; D011787:Quality of Health Care / Q000458:organization & administration; D019114:Remote Consultation / Q000458:organization & administration*