Clinical trial NCT04591873: Using Telemedicine to Optimize Teamwork and Infection Control of Critical and Highly-infectious Patients in an Emergency Department
Official title: Application of Telemedicine to Optimize Teamwork and Infection Control of Critical Patients in Isolation Rooms in the Emergency Department During Novel Coronavirus Disease 2019 Outbreak
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Critical Illness
Infections, Respiratory
Emergency Service, Hospital
Telemedicine
Keywords: telemedicine
isolation
critical care
emergency medicine
COVID-19
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2020-10-19
Enrollment: 74
Sex: ALL
Minimum age (years): 20
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients triaged as highly-infectious patients, needed to be treated in isolation rooms in the emergency department.

Brief summary: Since 2000, various emerging infectious diseases have repeatedly caused serious impact on the health of the global population and the healthcare systems. With the growing international transportation and improving accessibility of the healthcare systems, hospitals have been inevitably the first sentinels dealing with emerging infectious diseases. The biological disasters, such as the Severe Acute Respiratory Syndrome (SARS) in 2003, the Middle East Respiratory Syndrome (MERS) outbreak in South Korean in 2015, and the Coronavirus disease 2019 (COVID-19) outbreak this year, challenged our vulnerable healthcare systems and caused great loss of lives.

Regarding the ongoing global epidemics and possible community outbreaks of the COVID-19, the management of biological disasters for an overcrowded emergency department should be planned. In the early 2020, the emergency department used a double-triage and telemedicine method to treat non-critical patient with suspected COVID-19. This application reduced the exposure time of the first responders and reserve adequate interview quality. However, for the critical patients treated in the isolated resuscitation rooms, the unique environment limited the teamwork and communication for the resuscitation team. These factors might led to poorer quality of critical care.

The investigators designed a telemedicine-teamwork model, which connected the isolation room, prepare room and nursing station by an video-conferencing system in the emergency department. This model try to break the barriers of space between the rooms and facilitate the teamwork communications between each unit. Besides, by providing a more efficient workflow, this model could lower the total exposure time for all workers in the contaminated area. This study was conducted to evaluate the benefits of the telemedicine-teamwork model and provide a practical, safe and effective alternative to critical care of the patients with suspected highly infectious diseases.


Eligibility criteria: For patients:

1.Patients triaged as highly-infectious patients, needed to be treated in isolation rooms in the emergency department.

For healthcare providers:

1. Those providers who participates in the critical care for the patients included in the study accordingly

Primary outcomes:
measure: time to complete intubation
timeFrame: immediately after intervention
Secondary outcomes:
measure: teamwork score
timeFrame: immediately after intervention
measure: exposure time in isolation rooms
timeFrame: immediately after intervention
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National Taiwan University Hospital
Study officials:
affiliation: National Taiwan University Hospital
name: Chien-Hao Lin, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lin CH, Lin HY, Wu SN, Tseng WP, Chen WT, Tien YT, Wu CY, Huang CH, Tsai MS. Using a telemedicine-assisted airway model to improve the communication and teamwork of tracheal intubation during the coronavirus disease 2019 pandemic. J Telemed Telecare. 2024 Aug;30(7):1140-1148. doi: 10.1177/1357633X221124175. Epub 2022 Sep 6.