title: Contributions of tele-intensive care unit (Tele-ICU) technology to quality of care and patient safety.
abstract: The deployment of remote monitoring of intensive care unit (ICU) patients, known as tele-ICU technology, promotes the efficient use of critical care resources. Although tele-ICU use has spread rapidly, the benefits vary widely among studies, and little is known about the specific characteristics of tele-ICU that provide benefits to patient care. The purpose of this study was to identify aspects of tele-ICU that contribute, whether positively or negatively, to care processes and patient outcomes. This study was not aimed at evaluating the impact of tele-ICU on care outcomes. We conducted a qualitative study using semistructured interviews. Sixty-one tele-ICU staff from 5 tele-ICUs participated in the study. We performed inductive content analysis and coded 722 pieces of text into 19 positive and 9 negative/neutral tele-ICU contributions to care processes and patient outcomes. We found that availability of extra resources can reduce on mortality and length of stay, that a tele-ICU could serve as a quality trigger to improve evidence-based medicine compliance, that tele-ICU can support medication management and improve medication safety, and that tele-ICU software alerts and monitoring by camera can help reduce the risk of patient falls and extubations. We also found that tele-ICU physicians can make poor care decisions leading to medication errors if they lack patient-related information. Moreover, the tele-ICU has no impact on patient care processes and outcomes when the technology is not accepted and used by ICU staff.
authors.affiliation: Anesthesiology and Critical Care Medicine Department, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Adjhaporn
authors.initials: A
authors.lastname: Khunlertkit
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
mesh_terms: D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007407:Interviews as Topic; D010043:Outcome and Process Assessment, Health Care; D061214:Patient Safety; D011787:Quality of Health Care; D017216:Telemedicine / Q000458:organization & administration*