Factors Affecting Staff Perceptions of Tele-ICU Service in Rural Hospitals.
BACKGROUND
Telemedicine is designed to increase access to specialist care, especially in settings distant from tertiary-care centers. One of the more established telemedicine applications in hospitals is the tele-intensive care unit (tele-ICU). Perceptions of tele-ICU users are not well studied. Thus, we undertook a study focused on assessing staff acceptance at multiple hospitals that had implemented a tele-ICU system.


METHODS
We designed a survey instrument that gathered perceptions on multiple facets of tele-ICU use and administered it to clinical and administrative staff at 28 hospitals that had implemented a tele-ICU system. We also conducted interviews at half of these hospitals to gain a deeper understanding of factors affecting staff perceptions of tele-ICU services.


RESULTS
The 145 survey respondents were generally positive about all facets of the service. Analyses found no significant differences in comparisons between critical access and larger hospitals or between clinical and administrative/managerial respondents, although a few differences between providers and nurses emerged. Respondents at hospitals averaging more tele-ICU use and that had implemented it longer were significantly (p<0.05) more positive in their responses on multiple survey items than other respondents. Interviews corroborated and provided insight into survey responses.


CONCLUSIONS
Tele-ICU was particularly valued when critical access hospitals retained critical care patients during special circumstances and when the tele-ICU hub could monitor patients to provide relief for local providers and nurses. Tele-ICU can aid rural hospitals, but multiple delivery models are warranted to meet disparate needs.
Marcia M
MM
Ward
Fred
F
Ullrich
Andrew J
AJ
Potter
A Clinton
AC
MacKinney
2Avera Health, Sioux Falls, South Dakota.
Sarah
S
Kappel
Keith J
KJ
Mueller
D007722:Health Knowledge, Attitudes, Practice; D006780:Hospitals, Rural; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D008505:Medical Staff, Hospital / Q000523:psychology*; D036301:Qualitative Research; D013023:South Dakota; D011795:Surveys and Questionnaires; D017216:Telemedicine
intensive care unit; staff perception; tele-intensive care unit; telemedicine