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Utilizing telemedicine in the ICU: Does it impact teamwork?
Title
Utilizing telemedicine in the ICU: Does it impact teamwork?.
Creator
Lazzara, Elizabeth, Salas, Eduardo, Jentsch, Florian, Sims, Valerie, Schulman, Carl, University of Central Florida
Abstract / Description
Adverse events and medical errors plague the healthcare system. Hospital acquired infections and teamwork are some of the biggest contributor to these adverse outcomes. In an effort to mitigate these problems, administrators and clinicians alike have developed mechanisms, such as telemedicine. However, little research has been conducted investigating the role of telemedicine on teamwork -- a fundamental component of quality patient care. The purpose of this study is to gain a better...
Show moreAdverse events and medical errors plague the healthcare system. Hospital acquired infections and teamwork are some of the biggest contributor to these adverse outcomes. In an effort to mitigate these problems, administrators and clinicians alike have developed mechanisms, such as telemedicine. However, little research has been conducted investigating the role of telemedicine on teamwork -- a fundamental component of quality patient care. The purpose of this study is to gain a better understanding of the impact of telemedicine on teamwork behaviors and subsequent teamwork attitudes and cognitions during a common medical task, rounds within the Trauma-Intensive Care Unit. To this end, rounds were conducted with and without telemedicine. During this 60 day period, 16 clinicians completed three surveys and 34 rounds were video recorded. The results of this study suggest that the relationships between teamwork attitudes, behaviors, cognitions, and outcomes are differential impacted under conditions with and without telemedicine. More specifically, telemedicine is associated with an increase in attendance and communication density. Meanwhile, it does not significantly impact teamwork attitudes or cognitions. The primary implications of these findings indicate that telemedicine is not the solution for improving all teamwork elements but yet it is not a complete detriment either.
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Date Issued
2013
Identifier
CFE0005103, ucf:50721
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0005103
Home Care Quality Effects of Remote Monitoring
Title
Home Care Quality Effects of Remote Monitoring.
Creator
Williams, Cynthia, Wan, Thomas, Oetjen, Dawn, Burg, Mary Ann, Zhang, Ning, University of Central Florida
Abstract / Description
Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in...
Show moreDespite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care.The purpose of the study was to examine the home care quality effects of remote monitoring technology in patients with heart failure and to provide an economic justification for its adoption and diffusion. It compared remote monitoring as a potential intervention strategy to a standard no-intervention group (without remote monitoring). Specifically, it analyzed remote monitoring as a viable strategy to decrease hospital readmissions and emergency department visits. It also compared the cost of remote monitoring against the current standard-of-care. The theoretical framework of Donabedian's Quality Model was used in the evaluation of remote monitoring. A retrospective posttest only, case control study design was used to test the degree which remote monitoring was effective in promoting health care quality (hospital readmissions and decreased emergency department visits). Retrospective chart reviews were performed using electronic medical records (EMR). Analysis of Variance, Path Analysis, Automatic Interaction Detector Analysis (Dtreg), and Cost Outcomes Ratio were used to test the hypotheses and validate the proposed theoretical model.No significant difference was noted in remote monitoring and usual care groups. Results suggested that remote monitoring does not statistically lead to a decrease in heart failure-related hospital readmissions and all-cause emergency department visits. Results of the cost ratio analysis suggested that there was no statistically significant difference in the net income between usual care and remote monitoring; however, data suggest that there were significant increases in cost and intensity of nursing utilization for the remote monitoring intervention. The Automatic Interaction Detector Analysis showed that the unfavorable results in hospital readmissions were due to a decrease in collaborative care and patient education prior to the recommendation for hospitalization. The role of nursing care, whether in hospital or community-based care, in heart failure management is critical to quality outcomes. As the field continues to consider the use of technology in health care, decision makers should think through the process of patient care such that preventable hospital readmissions are decreased and patients received quality care.
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Date Issued
2014
Identifier
CFE0005442, ucf:50383
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0005442
ANTICIPATED TELEHEALTH DEVICE USAGE IN YOUNGER ADULTS
Title
ANTICIPATED TELEHEALTH DEVICE USAGE IN YOUNGER ADULTS.
Creator
Bull, Tyler, Szalma, James, University of Central Florida
Abstract / Description
Telehealth and telemedicine have revolutionized the healthcare system in terms of access to information and remote medical treatment. While there is a great deal of literature on current perceptions of telehealth care systems, relatively little is known about perceived user needs and acceptance of future telehealth systems. One way to assess future attitudes is to evaluate anticipated usage of telehealth devices through perceived advantages and disadvantages. Additionally, this study seeks to...
Show moreTelehealth and telemedicine have revolutionized the healthcare system in terms of access to information and remote medical treatment. While there is a great deal of literature on current perceptions of telehealth care systems, relatively little is known about perceived user needs and acceptance of future telehealth systems. One way to assess future attitudes is to evaluate anticipated usage of telehealth devices through perceived advantages and disadvantages. Additionally, this study seeks to assess the reliability of a new measure of technology acceptance that capitalizes on human motivation using self-determination theory. An online survey consisted of an original 40-item measure of motivation to use telehealth technology, the Psychosocial Impact of Assistive Devices Scale (PIADS; Jutai & Day, 1996), questions adapted from Edwards et al. (2014) about perceived advantages and disadvantages of telehealth devices, and open-ended questions about advantages, disadvantages, and concerns of interacting with telehealth devices in the future. The open-ended questions were coded for themes. Results also indicated that there was a high reliability between the MUTT and the PIADS, however the MUTT was slightly more reliable. Significant correlations were found between the overall MUTT and subscales of autonomy, competence, relatedness, and goals, as well as moderate correlations between the subscales of the PIADS (i.e., competence, adaptability, self-esteem) and the MUTT. The results of this research will be discussed further.
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Date Issued
2015
Identifier
CFH0004794, ucf:45338
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004794
AN INVESTIGATION OF THE ECONOMIC VIABILITY AND ETHICAL RAMIFICATIONS OF VIDEO SURVEILLANCE IN THE ICU
Title
AN INVESTIGATION OF THE ECONOMIC VIABILITY AND ETHICAL RAMIFICATIONS OF VIDEO SURVEILLANCE IN THE ICU.
Creator
Bagge, Laura, Heglund, Stephen, University of Central Florida
Abstract / Description
The purpose of this review of literature is to investigate the various roles of video surveillance (VS) in the hospital's intensive care unit (ICU) as well as its legal and ethical implications. Today, hospitals spend more money on the ICU than on any other unit. By 2030, the population of those 65 and over is expected to double. 80% of older adults have at least one chronic diseases (Centers for Disease Control and Prevention, 2013). As a consequence, the demand for ICU services will likely...
Show moreThe purpose of this review of literature is to investigate the various roles of video surveillance (VS) in the hospital's intensive care unit (ICU) as well as its legal and ethical implications. Today, hospitals spend more money on the ICU than on any other unit. By 2030, the population of those 65 and over is expected to double. 80% of older adults have at least one chronic diseases (Centers for Disease Control and Prevention, 2013). As a consequence, the demand for ICU services will likely increase, which may burden hospital with additional costs.. Because of increasing economic pressures, more hospitals are using video surveillance to enhance quality care and reduce ICU costs (Goran, 2012). Research shows that VS enhances positive outcomes among patients and best practice compliance among hospital staff. The results are fewer reports of patient complications and days spent in the ICU, and an increase in reported hospital savings. In addition, VS is becoming an important tool for the families of newborns in the neonatal ICU (NICU). The belief is that the VS can facilitate parent-baby bonding. In the United States of America, privacy rights impose legal restrictions on VS. These rights come from the U.S. Constitution, Statutory law, Regulatory law, and State law. HIPPA authorizes the patient to control the use and disclosure of his or her health information. Accordingly, hospitals are under obligation to inform patients on their right to protected health information. It is appropriate that hospitals use VS for diagnostic purposes as long as they have obtained patient consent. According to modern day privacy experts Charles Fried and Alan Westin, a violation of a person's privacy equates a violation on their liberty and morality. However, if a physician suspects that a third party person is causing harm to the patient, than the use of covert VS is justifiable.
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Date Issued
2013
Identifier
CFH0004475, ucf:45138
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004475