Utilizing telemedicine in the trauma intensive care unit: does it impact teamwork?

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Authors
Lazzara, Elizabeth H.
Benishek, Lauren E.
Patzer, Brady S.
Gregory, Megan E.
Hughes, Ashley M.
Heyne, Kyle
Salas, Eduardo
Kuchkarian, Fernanda
Marttos, Antonio
Schulman, Carl
Advisors
Issue Date
2015-08-01
Type
Article
Keywords
Emergency medicine , Teletrauma , Telemedicine , Telehealth , Telecommunications
Research Projects
Organizational Units
Journal Issue
Citation
Lazzara Elizabeth H., Benishek Lauren E., Patzer Brady, Gregory Megan E., Hughes Ashley M., Heyne Kyle, Salas Eduardo, Kuchkarian Fernanda, Marttos Antonio, and Schulman Carl. Telemedicine and e-Health. August 2015, 21(8): 670-676
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.

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Publisher
Mary Ann Liebert, Inc.
Journal
Book Title
Series
Telemedicine and e-Health;v.21:no.8
PubMed ID
DOI
ISSN
1530-5627
EISSN