Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial
Authors' conclusion
A telemedical quality improvement program increased adherence to seven evidence-based German performance indicators in acute ICU care.
Study context
- Population
- Adult ICU patients with expected ICU stay ≥ 24 h in 12 ICU clusters in Berlin and Brandenburg, Germany10 clusters
- Participants
- 1,463 patients
- Comparison
- Telemedicine vs standard care
- Telemedicinen = 1,049
- Standard caren = 414reference
- Primary endpoint
- Co-primary: patient-specific daily adherence (fulfilled yes/no) to German ICU QIs, centrally adjudicated
Methodological detailsinvestigator-initiated, open-label, multicentre, Two randomised clusters recruited no patients (one withdrew consent; one dropped out)
- Investigator-initiated
- Open-label
- Multicentre
- Two randomised clusters recruited no patients (one withdrew consent; one dropped out)
Primary result
As reported in the abstract
Patient-specific daily adherence to German acute ICU care QIs (co-primary)
- Telemedicine increased adherence to "sedation, analgesia and delirium" QI, aOR
- 5.328, 3.395-8.358 (99.375% CI)
- Telemedicine increased adherence to "ventilation" QI, OR
- 2.248, 1.198-4.217 (99.375% CI)
- Telemedicine increased adherence to "weaning from ventilation" QI, OR
- 9.049, 2.707-30.247 (99.375% CI)
- Telemedicine increased adherence to "infection management" QI, OR
- 4.397, 1.482-13.037 (99.375% CI)
- Telemedicine increased adherence to "enteral nutrition" QI, OR
- 1.579, 1.032-2.416 (99.375% CI)
- Telemedicine increased adherence to "patient and family communication" QI, OR
- 6.787, 3.976-11.589 (99.375% CI)
- Telemedicine increased adherence to "early mobilisation" QI, OR
- 3.161, 2.160-4.624 (99.375% CI)
- No evidence for a difference in adherence to "daily multi-professional and interdisciplinary clinical visits" QI, OR
- 1.606, 0.780-3.309 (99.375% CI)
Further findings
Events
| Outcome | Telemedicine | Standard care |
|---|---|---|
| Death during index ICU stay | 104 | 45 |
- Death during index ICU stay: 149 patients died in total
Original publication
Effectiveness of an intensive care telehealth programme to improve process quality (ERIC): a multicentre stepped wedge cluster randomised controlled trial. Intensive Care Med. Published 16 January 2023. doi:10.
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