Does Robotic Telerounding Enhance Nurse-Physician Collaboration Satisfaction About Care Decisions?
BACKGROUND
Delivering healthcare using remote robotic telepresence is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships in intensive care units. Our study assessed the nurse-physician collaboration satisfaction about care decisions from surgical intensive critical care nurses during remote robotic telepresence night rounds in comparison with conventional telephone night rounds.


METHODS
This study used a randomized trial to test whether robotic telerounding enhances the nurse-physician collaboration satisfaction about care decisions. A physician randomly used either the conventional telephone or the RP-7 robot (InTouch(®) Health, Santa Barbara, CA) to perform nighttime rounding in a surgical intensive care unit. The Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of ≤0.05.


RESULTS
From December 1, 2011 to December 13, 2012, 20 off-shift nurses submitted 106 surveys during telephone rounds and 108 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (51.3 versus 50.5; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (51.3 versus 43.0; p=0.01), in comparison with telephone rounds (50.5 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone).


CONCLUSIONS
Robot rounding in the intensive care unit was comparable but not superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of intensive care nurses did not contribute to the preference of night shift rounding method from the aspect of collaboration with the physician about care decision-making.
1 Surgical Intensive Care Unit, Lahey Hospital & Medical Center , Burlington, Massachusetts.
Michele
M
Bettinelli
2 Department of Pulmonary & Critical Care Medicine, Lahey Hospital & Medical Center , Burlington, Massachusetts.
Yuxiu
Y
Lei
3 Sloan School of Management, Massachusetts Institute of Technology , Cambridge, Massachusetts.
Matt
M
Beane
4 Department of Pulmonary & Critical Care Medicine, Riverside Methodist Hospital , Columbus, Ohio.
Caleb
C
Mackey
2 Department of Pulmonary & Critical Care Medicine, Lahey Hospital & Medical Center , Burlington, Massachusetts.
Timothy N
TN
Liesching
D000328:Adult; D003142:Communication; D003299:Cooperative Behavior; D003422:Critical Care; D064648:Critical Care Nursing; D018592:Cross-Over Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007318:Inservice Training; D007588:Job Satisfaction; D008297:Male; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D011446:Prospective Studies; D019114:Remote Consultation / Q000295:instrumentation*; D012371:Robotics / Q000295:instrumentation*; D013689:Telephone
telecommunications; telehealth; telemedicine; telenursing