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New ALERT - Live vs. Telepresence Team Leader on Teamwork & Communication

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Butler L (Yale), Auerbach MA

Published in: Health & Medicine
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New ALERT - Live vs. Telepresence Team Leader on Teamwork & Communication

  1. 1. ALERT Presentation: Impact of physical presence vs. telepresence of team leader on teamwork and communication in simulated pediatric emergency cases: an RCT Lucas Butler Yale School of Medicine INSPIRE @ IMSH 2016 – San Diego, CA / USA International Network for Simulation-based Pediatric Innovation, Research and Education
  2. 2. • Telemed consults used in critical community ED peds cases • Little front-end research guiding implementation and best uses for this technology • Paucity of rigorous research on impact of telemed on quality of care in peds emergency cases • No research on teamwork—crucial contributor to outcomes— in peds emergency telemed cases (despite clear change in team dynamic when team leader physically absent) International Network for Simulation-based Pediatric Innovation, Research and Education Background
  3. 3. • P: resident peds and EM teams (Sr., Jr., intern/PA/RN) • I: team leader (Sr. resident) on videoconference • C: team leader in room (normal sim) • O: 1°STAT human factors score 2°STAT clinical skills score 3°teamwork/workload self-assessments International Network for Simulation-based Pediatric Innovation, Research and Education PICO / Research Question
  4. 4. • Recruit 18 teams of 3-4 resident/PA/RN • Randomize. Intervention= TL on videoconference (multiple views of room and monitors) International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design
  5. 5. • Demographic data survey • Run sim for which STAT validated (see next slide) • Scripted debriefing, gather qualitative data on perspectives of telemed’s impact on teamwork • Self-assessment surveys: teamwork & workload • Review case videos, score with STAT tool International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design cont.
  6. 6. • Simulation: – Scenario: 2 y.o. in septic shock with subsequent apnea and Vfib – Location: Yale Sim Center (AV control room, sim technician) – Manikin: Laerdal SimBaby – Equipment: B-Line SimCapture (bird’s eye, room, monitor views) • Data Collection Instruments: – STAT tool – Demographic data survey – Post-sim subjective assessments of leadership and overall teamwork International Network for Simulation-based Pediatric Innovation, Research and Education Design—Case & Instrument
  7. 7. • Independent two-sample t-tests • Calculated sample size n=18 • Gather qualitative data during scripted debriefing International Network for Simulation-based Pediatric Innovation, Research and Education Methods—analyses
  8. 8. • H 1: Teamwork improved due to: + Increased team member idea-sharing & engagement in decision-making + More “huddles” and sharing of mental model + Increased verbal communication, improved closed-loop communication - Decreased non-verbal communication • H 2: Quality of care increased + Decreased TL task fixation/distractions + Reduced team anxiety - Reduced team structure/clearly defined roles given lack of TL physical presence - Most skilled person physically outside room • H 4: Decreased self-reported TL leadership skills by TL & team International Network for Simulation-based Pediatric Innovation, Research and Education Hypotheses
  9. 9. • ALERT Presentation—Jan 15, 2016 • Grant Proposal (if applicable)—N/A • IRB Submission—10/30/2015 • Recruitment/Data Collection—pilot Nov 16, testing Jan-Mar ‘16 • Data Analysis—March-April 2016 • Abstract Presentation—May 2016 • Manuscript Preparation—June 2016 International Network for Simulation-based Pediatric Innovation, Research and Education Timeline
  10. 10. 1. Proper choice of data collection tools/forms? 2. Will this work generalize to non-pediatric cases and non-resident providers? 3. Right # of data collection forms to amass sufficient data without overburdening subjects? International Network for Simulation-based Pediatric Innovation, Research and Education 4 questions to improve study
  11. 11. At INSPIRE @ IMSH 2016: Feedback/direction from industry experts, network with others interested in telemed/sim/teamwork In 2 months: Introduction & methods written, enrolling subjects, all study elements in place International Network for Simulation-based Pediatric Innovation, Research and Education Goals to accomplish
  12. 12. Lucas Butler Yale Medical School lucas.butler@yale.edu, 203-215-1111 International Network for Simulation-based Pediatric Innovation, Research and Education Contact Information

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