ICU Telemedicine Comanagement Methods and Length of Stay
Abstract
Background Studies have identified processes that are associated with more favorable length of stay (LOS) outcomes when an ICU telemedicine program is implemented. Despite these studies, the relation of the acceptance of ICU telemedicine management services by individual ICUs to LOS outcomes is unknown.Methods This is a single ICU telemedicine center study that compares LOS outcomes among three groups of intensivist-staffed mixed medical-surgical ICUs that used alternative comanagement strategies. The proportion of provider orders recorded by an ICU telemedicine provider to all recorded orders was compared among ICUs that used a monitor and notify comanagement approach, a direct intervention with timely notification process, and ICUs that used a mix of these two approaches. The primary outcome was acuity-adjusted hospital LOS.Results ICUs that used the direct intervention with timely notification strategy had a significantly larger proportion of provider orders recorded by ICU telemedicine physicians than the mixed methods of comanagement group, which had a larger proportion than ICUs that used the monitor and notify method (P < .001). Acuity-adjusted hospital LOS was significantly lower for the direct intervention with timely notification comanagement strategy (0.68; 0.65-0.70) compared with the mixed methods group (0.70 [0.69-0.72]; P = .01), which was significantly lower than the monitor and notify group (0.83 [0.80-0.86]; P < .001).Conclusions Direct intervention with timely notification strategies of ICU telemedicine comanagement were associated with shorter LOS outcomes than monitor and notify comanagement strategies.
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Length of stay in the ICU could be reduced through the utilization of remote patient monitoring.
“ICU staff claimed that the length of stay in the ICU could be reduced through the utilization of remote patient monitoring, which is in line with several recent studies on telemedicine [44,45].”
From Clinical requirements of future patient monitoring in the intensive care unit: qualitative study (2019) · cites this paper as [45]
Cites
Donabedian, A. (1988) · JAMA · doi:10.1001/jama.260.12.1743 · Cited by 5,895 · see citing works
The APACHE III Prognostic System
Knaus, W. A., Wagner, D. P., Draper, E. A., Zimmerman, J. E., Bergner, M., BASTOS, P. G., Sirio, C., Murphy, D. J., Lotring, T., Damiano, A., et al. (1991) · CHEST Journal · doi:10.1378/chest.100.6.1619 · Cited by 3,524 · see citing works
The APACHE III Prognostic System
Teres, D., & Lemeshow, S. A. (1992) · CHEST Journal · doi:10.1378/chest.102.6.1919b · Cited by 2,880 · see citing works
Research Methods in Applied Settings: An Integrated Approach to Design and Analysis
Gliner, J. A., Morgan, G. A., & Leech, N. L. (2000) · Cited by 753 · see citing works
Angus, D. C., Shorr, A. F., White, A., Dremsizov, T. T., Schmitz, R. J., & Kelley, M. A. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000206105.05626.15 · Cited by 440 · see citing works
The effect of telemedicine in critically ill patients: systematic review and meta-analysis
Wilcox, M. E., & Adhikari, N. K. J. (2012) · Critical Care · doi:10.1186/cc11429 · Cited by 228 · see citing works
A Multicenter Study of ICU Telemedicine Reengineering of Adult Critical Care
Lilly, C. M., McLaughlin, J. M., Zhao, H., Baker, S. P., Cody, S. E., & Irwin, R. S. (2014) · CHEST Journal · doi:10.1378/chest.13-1973 · Cited by 218 · see citing works
Self-citationLilly, C. M., Zubrow, M. T., Kempner, K. M., Reynolds, H. N., Subramanian, S., Eriksson, E. A., Jenkins, C. L., Rincon, T., Kohl, B., Groves, R. H., et al. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000539 · Cited by 161 · see citing works
Self-citationMcCambridge, M. M., Jones, K., Paxton, H., et al. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.74 · Cited by 108 · see citing works
Staff Acceptance of Tele-ICU Coverage
Young, L. B., Chan, P. S., & Cram, P. M. (2010) · CHEST Journal · doi:10.1378/chest.10-1795 · Cited by 103 · see citing works
The Research Agenda in ICU Telemedicine
Kahn, J. M., Hill, N. S., Lilly, C. M., Angus, D. C., Jacobi, J., Rubenfeld, G. D., Rothschild, J. M., Sales, A. E., Scales, D. C., & Mathers, J. A. L. (2011) · CHEST Journal · doi:10.1378/chest.11-0610 · Cited by 93 · see citing works
Self-citationRepublished: United States Registered Nurse Workforce Report Card and Shortage Forecast
Juraschek, S. P., Zhang, X., Ranganathan, V. K., & Lin, V. W.-H. (2019) · American Journal of Medical Quality · doi:10.1177/1062860619873217 · Cited by 79 · see citing works
Reynolds, H. N., Rogove, H., Bander, J. J., McCambridge, M., Cowboy, E., & Niemeier, M. R. (2011) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2011.0045 · Cited by 67 · see citing works
A National ICU Telemedicine Survey
Lilly, C. M., Fisher, K. A., Ries, M. H., Pastores, S. M., Vender, J. S., Pitts, J. A., & Hanson, C. W. (2012) · CHEST Journal · doi:10.1378/chest.12-0310 · Cited by 64 · see citing works
Self-citationLee, H., Shon, Y.-J., Kim, H., et al. (2014) · Korean Journal of Anesthesiology · doi:10.4097/kjae.2014.67.2.115 · Cited by 51 · see citing works
Fuhrman, S. A., & Lilly, C. M. (2015) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2015.05.004 · Cited by 36 · see citing works
Self-citationThe Burden of the U.S. Crisis in the Surgical Critical Care Workforce and Workflow
Sarani, B., Toevs, C. C., Mayglothling, J., et al. (2015) · The American Surgeon · doi:10.1177/000313481508100114 · Cited by 15 · see citing works
Kahn, K. L., Mendel, P. J., Leuschner, K. J., Hiatt, L., Gall, E. M., Siegel, S., & Weinberg, D. A. (2014) · PubMed · doi:10.1097/mlr.0000000000000084 · Cited by 6 · see citing works
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Clinical requirements of future patient monitoring in the intensive care unit: qualitative study
Poncette, A.-S., Spies, C., Mosch, L., Schieler, M., Weber-Carstens, S., Krampe, H., & Balzer, F. (2019) · JMIR Medical Informatics · doi:10.2196/13064 · Cited by 136 · see citing works
Brief training increases nurses' comfort using tele-ultrasound: A feasibility study
Douglas, T. M., Levine, A. R., Olivieri, P. P., McCurdy, M. T., Papali, A., Zubrow, M. T., Rodick, K. M., Hurley, J. M., & Verceles, A. C. (2019) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2018.11.004 · Cited by 20 · see citing works
- Authors
- Hawkins, H. A., Lilly, C. M., Kaster, D. A., Groves, R. H., & Khurana, H.
- Affiliations
- Colorado State University (US)
- University of Massachusetts Chan Medical School (US)
- Banner Health (US)
- Corresponding author
- Khurana, Hargobind
- ORCID
- Lilly, Craig M.
- Venue
- CHEST
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 150
- Issue
- 2
- Pages
- 314-319
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2313498007
- Cited by
- 49
- References
- 18
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 13 · 2018: 10 · 2017: 5 · 2016: 1
- FWCI
- 9.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- length of hospital stay, intensivist staffing, intensive care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cooperative Behavior, Critical Care, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Retrospective Studies, Hospital Mortality, Telemedicine, APACHE, Early Medical Intervention
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