Utilizing Telemedicine in the Trauma Intensive Care Unit: Does It Impact Teamwork?

Elizabeth H. Lazzara, Lauren E. Benishek, Brady Patzer, Megan E. Gregory, Ashley M. Hughes, Kyle Heyne, Eduardo Salas, Fernanda Kuchkarian, Antonio Marttos, Jr, Carl I Schulman

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: The aim of this study was to examine the impact of a telemedical robot on trauma intensive care unit (TICU) clinician teamwork (i.e., team attitudes, behaviors, and cognitions) during patient rounds.

MATERIALS AND METHODS: Thirty-two healthcare providers who conduct rounds volunteered to take surveys assessing teamwork attitudes and cognitions at three time periods: (1) the onset of the study, (2) the end of the 30-day control period, and (3) the end of the 30-day experimental period, which immediately followed the control period. Rounds were recorded throughout the 30-day control period and 30-day experimental period to observe provider behaviors. For the initial 30 days, there was no access to telemedicine. For the final 30 days, the rounding healthcare providers had access to the RP-7 robot (Intouch Health Inc., Santa Barbara, CA), a telemedical tool that can facilitate patient rounds conducted away from bedside.

RESULTS: Using a one-tailed, one-way repeated-measures analysis of variance (ANOVA) to compare trust at Times 1, 2, and 3, there was no significant effect on trust: F(2, 14)=1.20, p=0.16. When a one-tailed, one-way repeated-measures ANOVA to compare transactive memory systems (TMS) at Times 1, 2, and 3 was conducted, there was no significant effect on TMS: F(2, 15)=1.33, p=0.15. We conducted a one-tailed, one-way repeated-measures ANOVA to compare team psychological safety at Times 1, 2, and 3, and there was no significant effect on team psychological safety: F(2,15)=1.53, p=0.12. There was a significant difference in communication between rounds with and without telemedicine [t(25)=-1.76, p<0.05], such that there was more task-based communication during telerounds. Telemedicine increased task-based communication and did not negatively impact team trust, psychological safety, or TMS during rounds.

CONCLUSIONS: Telemedicine may offer advantages for some teamwork competencies without sacrificing the efficacy of others and may be adopted by intact rounding teams without hindering teamwork.

Original languageEnglish (US)
Pages (from-to)670-676
Number of pages7
JournalTelemedicine journal and e-health : the official journal of the American Telemedicine Association
Volume21
Issue number8
DOIs
StatePublished - Aug 1 2015

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Telemedicine
Intensive Care Units
Analysis of Variance
Communication
Wounds and Injuries
Psychology
Safety
Health Personnel
Cognition
Health

Keywords

  • emergency medicine/teletrauma
  • telecommunications
  • telehealth
  • telemedicine

ASJC Scopus subject areas

  • Medicine(all)
  • Health Informatics
  • Health Information Management

Cite this

Utilizing Telemedicine in the Trauma Intensive Care Unit : Does It Impact Teamwork? / Lazzara, Elizabeth H.; Benishek, Lauren E.; Patzer, Brady; Gregory, Megan E.; Hughes, Ashley M.; Heyne, Kyle; Salas, Eduardo; Kuchkarian, Fernanda; Marttos, Jr, Antonio; Schulman, Carl I.

In: Telemedicine journal and e-health : the official journal of the American Telemedicine Association, Vol. 21, No. 8, 01.08.2015, p. 670-676.

Research output: Contribution to journalArticle

Lazzara, EH, Benishek, LE, Patzer, B, Gregory, ME, Hughes, AM, Heyne, K, Salas, E, Kuchkarian, F, Marttos, Jr, A & Schulman, CI 2015, 'Utilizing Telemedicine in the Trauma Intensive Care Unit: Does It Impact Teamwork?', Telemedicine journal and e-health : the official journal of the American Telemedicine Association, vol. 21, no. 8, pp. 670-676. https://doi.org/10.1089/tmj.2014.0074
Lazzara, Elizabeth H. ; Benishek, Lauren E. ; Patzer, Brady ; Gregory, Megan E. ; Hughes, Ashley M. ; Heyne, Kyle ; Salas, Eduardo ; Kuchkarian, Fernanda ; Marttos, Jr, Antonio ; Schulman, Carl I. / Utilizing Telemedicine in the Trauma Intensive Care Unit : Does It Impact Teamwork?. In: Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 2015 ; Vol. 21, No. 8. pp. 670-676.
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N2 - BACKGROUND: The aim of this study was to examine the impact of a telemedical robot on trauma intensive care unit (TICU) clinician teamwork (i.e., team attitudes, behaviors, and cognitions) during patient rounds.MATERIALS AND METHODS: Thirty-two healthcare providers who conduct rounds volunteered to take surveys assessing teamwork attitudes and cognitions at three time periods: (1) the onset of the study, (2) the end of the 30-day control period, and (3) the end of the 30-day experimental period, which immediately followed the control period. Rounds were recorded throughout the 30-day control period and 30-day experimental period to observe provider behaviors. For the initial 30 days, there was no access to telemedicine. For the final 30 days, the rounding healthcare providers had access to the RP-7 robot (Intouch Health Inc., Santa Barbara, CA), a telemedical tool that can facilitate patient rounds conducted away from bedside.RESULTS: Using a one-tailed, one-way repeated-measures analysis of variance (ANOVA) to compare trust at Times 1, 2, and 3, there was no significant effect on trust: F(2, 14)=1.20, p=0.16. When a one-tailed, one-way repeated-measures ANOVA to compare transactive memory systems (TMS) at Times 1, 2, and 3 was conducted, there was no significant effect on TMS: F(2, 15)=1.33, p=0.15. We conducted a one-tailed, one-way repeated-measures ANOVA to compare team psychological safety at Times 1, 2, and 3, and there was no significant effect on team psychological safety: F(2,15)=1.53, p=0.12. There was a significant difference in communication between rounds with and without telemedicine [t(25)=-1.76, p<0.05], such that there was more task-based communication during telerounds. Telemedicine increased task-based communication and did not negatively impact team trust, psychological safety, or TMS during rounds.CONCLUSIONS: Telemedicine may offer advantages for some teamwork competencies without sacrificing the efficacy of others and may be adopted by intact rounding teams without hindering teamwork.

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