Journal article
Utilized or Underutilized: A Qualitative Analysis of Building Coherence During Early Implementation of a Tele-Intensive Care Unit
Telemedicine journal and e-health, Vol.26(9), pp.1167-1177
01/10/2020
DOI: 10.1089/tmj.2019.0135
PMID: 31928388
Abstract
Generating, reading, or interpreting data is a component of Telemedicine-Intensive Care Unit (Tele-ICU) utilization that has not been explored in the literature.
Using the idea of "coherence," a construct of Normalization Process Theory, we describe how intensive care unit (ICU) and Tele-ICU staff made sense of their shared work and how they made use of Tele-ICU together.
We interviewed ICU and Tele-ICU staff involved in the implementation of Tele-ICU during site visits to a Tele-ICU hub and 3 ICUs, at preimplementation (43 interviews with 65 participants) and 6 months postimplementation (44 interviews with 67 participants). Data were analyzed using deductive coding techniques and lexical searches.
In the early implementation of Tele-ICU, ICU and Tele-ICU staff lacked consensus about how to share information and consequently how to make use of innovations in data tracking and interpretation offered by the Tele-ICU (e.g., acuity systems). Attempts to collaborate and create opportunities for utilization were supported by quality improvement (QI) initiatives.
Characterizing Tele-ICU utilization as an element of a QI process limited how ICU staff understood Tele-ICU as an innovation. It also did not promote an understanding of how the Tele-ICU used data and may therefore attenuate the larger promise of Tele-ICU as a potential tool for leveraging big data in critical care.
Shared data practices lay the foundation for Tele-ICU program utilization but raise new questions about how the promise of big data can be operationalized for bedside ICU staff.
Details
- Title: Subtitle
- Utilized or Underutilized: A Qualitative Analysis of Building Coherence During Early Implementation of a Tele-Intensive Care Unit
- Creators
- Jennifer M Van Tiem - The Center for Access and Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IowaJulia E Friberg - The Center for Access and Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IowaJaime R Wilson - Department of Nursing, University of Iowa Hospitals and Clinics, Iowa City, IowaLynn Fitzwater - VISN 10/Cincinnati Tele-ICU System, Cincinnati, OhioJames M Blum - Department of Anesthesiology, Emory University School of Medicine, Atlanta, GeorgiaRalph J Panos - VISN 10/Cincinnati Tele-ICU System, Cincinnati, OhioHeather Schacht Reisinger - The Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaJane Moeckli - The Center for Access and Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.26(9), pp.1167-1177
- Publisher
- United States
- DOI
- 10.1089/tmj.2019.0135
- PMID
- 31928388
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Language
- English
- Date published
- 01/10/2020
- Academic Unit
- Iowa Technology Institute; Nursing; Center for Social Science Innovation; Anesthesia; Internal Medicine
- Record Identifier
- 9984013163702771
Metrics
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