: A powerful influence on the quality of care in intensive care units (ICUs) is the presence of critical care physicians (intensivists) in the unit. High-intensity intensivist staffing (required intensivist consultation or closed ICU where intensivists see all patients) is associated with a 29 percent reduction in hospital mortality and a 49 percent reduction in ICU mortality. However, only 10-15 percent of U.S. hospitals have high-intensity staffing by intensivists, primarily due to an existing and worsening shortage of intensivists. Telemedicine, a common form of health information technology, has been used to provide remote intensivist monitoring for ICUs via a tele-ICU. The only study of remote ICU monitoring with a tele-ICU found a reduction in mortality and length of stay comparable to on-site intensivist staffing. More research is needed because of limitations with this single study, the growing demand for intensivist coverage in ICUs, the shortage of intensivists, and the possible effectiveness of tele-ICUs. ? ? The specific aims of this study are: ? ? 1. To measure the effect of a tele-ICU on mortality, complications, and length of stay in ICUs in a tertiary care teaching hospital, and in seven community (including two """"""""small"""""""") hospitals using a pre- and post-intervention study design. ? ? 2. To measure the cost-effectiveness of the tele-ICU. ? ? 3. To use human factors engineering techniques to determine how changes to the user interface of the tele-ICU may increase the value of the technology. ? ? 4. To measure changes in healthcare provider attitudes about teamwork and safety climate after implementation of the tele-ICU. ?

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
1R01HS015234-01
Application #
6890509
Study Section
Special Emphasis Panel (ZHS1-HSR-H (01))
Program Officer
Chiang, Yen-Pin
Project Start
2004-09-30
Project End
2007-09-29
Budget Start
2004-09-30
Budget End
2005-09-29
Support Year
1
Fiscal Year
2004
Total Cost
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225
Franzini, Luisa; Sail, Kavita R; Thomas, Eric J et al. (2011) Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system. J Crit Care 26:329.e1-6
Chu-Weininger, M Y L; Wueste, L; Lucke, J F et al. (2010) The impact of a tele-ICU on provider attitudes about teamwork and safety climate. Qual Saf Health Care 19:e39
Thomas, Eric J; Lucke, Joseph F; Wueste, Laura et al. (2009) Association of telemedicine for remote monitoring of intensive care patients with mortality, complications, and length of stay. JAMA 302:2671-8