QUERI Citations
Goedken CC, Moeckli J, Cram PM, Reisinger HS. Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits. Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses. 2017 Jun 1; 40:51-56.
Abstract:
OBJECTIVE:
This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation.
METHODS:
We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013. Transcripts were analysed for thematic content.
FINDINGS:
Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation.
CONCLUSIONS:
ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals.