Collaboration Between Tele-ICU Programs Has the Potential to Rapidly Increase the Availability of Critical Care Physicians—Our Experience Was During Coronavirus Disease 2019 Nomenclature

Chandra, Satya V.; Hertz, Craig; Khurana, Hargobind; Doerfler, Martin E.

doi:10.1097/cce.0000000000000363

Cited by 15 publications

(8 citation statements)

References 6 publications

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“…Barbash et al (44) detailed the urgent deployment of a telemedicine program at New York Presbyterian Hospital with the support and collaboration of two other large healthcare systems, University of Pittsburgh Medical Center (UPMC) and Mayo Clinic. This occurred at the same time that UPMC was implementing a system-level ICU pandemic surge staffing plan (65, 67). The use of tele-augmentation is shown graphically in Figure 2 .…”

Section: Discussionmentioning

confidence: 99%

Flow-Sizing Critical Care Resources*

Nates

Oropello

Badjatia

et al. 2023

Critical Care Medicine

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OBJECTIVES: To describe the factors affecting critical care capacity and how critical care organizations (CCOs) within academic centers in the U.S. flow-size critical care resources under normal operations, strain, and surge conditions. DATA SOURCES: PubMed, federal agency and American Hospital Association reports, and previous CCO survey results were reviewed. STUDY SELECTION: Studies and reports of critical care bed capacity and utilization within CCOs and in the United States were selected. DATA EXTRACTION: The Academic Leaders in the Critical Care Medicine Task Force established regular conference calls to reach a consensus on the approach of CCOs to “flow-sizing” critical care services. DATA SYNTHESIS: The approach of CCOs to “flow-sizing” critical care is outlined. The vertical (relation to institutional resources, e.g., space allocation, equipment, personnel redistribution) and horizontal (interdepartmental, e.g., emergency department, operating room, inpatient floors) integration of critical care delivery (ICUs, rapid response) for healthcare organizations and the methods by which CCOs flow-size critical care during normal operations, strain, and surge conditions are described. The advantages, barriers, and recommendations for the rapid and efficient scaling of critical care operations via a CCO structure are explained. Comprehensive guidance and resources for the development of “flow-sizing” capability by a CCO within a healthcare organization are provided. CONCLUSIONS: We identified and summarized the fundamental principles affecting critical care capacity. The taskforce highlighted the advantages of the CCO governance model to achieve rapid and cost-effective “flow-sizing” of critical care services and provide recommendations and resources to facilitate this capability. The relevance of a comprehensive approach to “flow-sizing” has become particularly relevant in the wake of the latest COVID-19 pandemic. In light of the growing risks of another extreme epidemic, planning for adequate capacity to confront the next critical care crisis is urgent.

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Section: Discussionmentioning

confidence: 99%

Flow-Sizing Critical Care Resources*

Nates

Oropello

Badjatia

et al. 2023

Critical Care Medicine

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“…The implementation of the Zoom hybrid round was feasible yet challenging in our PICU setting. The utilization of technology as a novel communication tool during the pandemic and tele-ICU was advocated in recent literature (7,11,12). During times of physical distancing, HCWs may find it helpful to use videoconferencing services to sustain professional meetings and continue educational activities using online platforms (11).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study

et al. 2021

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Objectives: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients.Design: Mixed quantitative and qualitative deductive thematic content analysis of narrative responses.Setting: PICU, single tertiary-care academic center.Participants: Multidisciplinary PICU HCWs.Interventions: Integration of Zoom meeting into clinical daily PICU rounds.Measurements: For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used.Main Results: The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), p < 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized.Conclusions: Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.

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“…The implementation of the Zoom hybrid round was feasible yet challenging in our PICU setting. The utilization of technology as novel communication tools during the pandemic and Tele-ICU was advocated in recent literature (7, 10, 11). During times of physical distancing, HCWs may find it helpful to use videoconferencing services to sustain professional meetings and continue educational activities using online platforms (10).…”

Section: Discussionmentioning

confidence: 99%

Pediatric intensive care hybrid-style clinical round during COVID-19 pandemic: A pilot study

Temsah

Alhaboob

Abouammoh

et al. 2021

Preprint

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Background: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted utilization of Zoom online into the clinical rounds to enhance communication among the treating team. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients from the HCWs' perspective. Methods: A mixed quantitative and qualitative deductive thematic content analysis of narrative responses from pediatric intensive care HCWs were analyzed, descriptive statistics were used Results: A total of 31 HCW were included in the analysis; the mean time of the virtual round was 72.45 minutes vs. 34.68 for physical rounds, the most shared component in the virtual round was CXR (93.5%). Some of the HCWs' perceived advantages of the hybrid rounds were enabling the multidisciplinary discussions, lesser round interruptions, and practicality of the virtual discussions. The perceived challenges were the difficulty of the bedside nurse to attend the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if the video streaming was not utilized. Conclusion: Hybrid virtual and physical clinical rounds in PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round could be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.

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Collaboration Between Tele-ICU Programs Has the Potential to Rapidly Increase the Availability of Critical Care Physicians—Our Experience Was During Coronavirus Disease 2019 Nomenclature

Cited by 15 publications

References 6 publications

Flow-Sizing Critical Care Resources*

Flow-Sizing Critical Care Resources*

Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study

Pediatric intensive care hybrid-style clinical round during COVID-19 pandemic: A pilot study

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