A Process Evaluation of ICU Telemedicine
Research type
Research Study
Full title
A Mixed Method Process Evaluation of the Implementation and Effectiveness of an ICU Telemedicine Programme at Guy’s and St. Thomas’ NHS Foundation Trust
IRAS ID
134330
Contact name
Jane Sandall
Contact email
Sponsor organisation
Kings College London
Research summary
Telemedicine uses audiovisual technology to provide diagnosis and patient care to sites at a distance from the provider. Given changing patients’ needs, the complexity of management of the critically ill and the need for additional critical care services, hospitals are starting to use telemedicine as a quality improvement strategy for the ICU. ICU telemedicine involves doctors and nurses linking remotely with bedside practitioners to help with monitoring patients’ physiologic status and laboratory studies, and oversee best practice adherence. While a recent systematic review suggests that ICU telemedicine is a promising intervention to improve outcomes in critically ill patients, little research has been directed at understanding the clinical and financial implications or potential unintended consequences. The optimal configuration and mechanisms of action remain unclear.
This research is linked to a trial (currently being planned) evaluating the impact of an ICU telemedicine system within one UK foundation Trust. The study presented here provides a process evaluation of implementation and effectiveness of the intervention and explores how the ICU telemedicine is made to work in practice. It will involve observation of the 6 participating critical care units before the intervention to assess how staff work together, make decisions and deliver care. These observations will continue on the units and the remotely located support centre once the ICU telemedicine has been introduced to assess changes in teamworking, care organisation and delivery. Patients, family members, board members, managers, doctors, nurses, allied health professionals and care assistants will be invited to participate in interviews to learn more about how they make sense of the technology and it shapes staff and user experiences, interprofessional working and patient safety practices. Staff will be surveyed before, during and after the intervention to assess how the intervention is being implemented, its acceptability and impact on staff burnout and safety culture.
REC name
London - Brent Research Ethics Committee
REC reference
14/LO/0105
Date of REC Opinion
14 Feb 2014
REC opinion
Further Information Favourable Opinion