Trial Outcomes & Findings for Telemedicine Control Tower for the Post-Anesthesia Care Unit (NCT NCT04020887)

NCT ID: NCT04020887

Last Updated: 2023-07-19

Results Overview

The difference in discharge readiness time between the observation and interaction phases will be compared

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

560 participants

Primary outcome timeframe

up to 1 day

Results posted on

2023-07-19

Participant Flow

Participant milestones

Participant milestones
Measure
Observation Phase
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Overall Study
STARTED
304
256
Overall Study
COMPLETED
304
256
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Telemedicine Control Tower for the Post-Anesthesia Care Unit

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Observation Phase
n=304 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=256 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Total
n=560 Participants
Total of all reporting groups
Age, Continuous
55.9 years
STANDARD_DEVIATION 15.7 • n=99 Participants
55.7 years
STANDARD_DEVIATION 15 • n=107 Participants
55.8 years
STANDARD_DEVIATION 15.4 • n=206 Participants
Sex: Female, Male
Female
194 Participants
n=99 Participants
157 Participants
n=107 Participants
351 Participants
n=206 Participants
Sex: Female, Male
Male
110 Participants
n=99 Participants
99 Participants
n=107 Participants
209 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=99 Participants
6 Participants
n=107 Participants
11 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
295 Participants
n=99 Participants
248 Participants
n=107 Participants
543 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
4 Participants
n=99 Participants
2 Participants
n=107 Participants
6 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
3 Participants
n=99 Participants
0 Participants
n=107 Participants
3 Participants
n=206 Participants
Race (NIH/OMB)
Asian
4 Participants
n=99 Participants
4 Participants
n=107 Participants
8 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
64 Participants
n=99 Participants
49 Participants
n=107 Participants
113 Participants
n=206 Participants
Race (NIH/OMB)
White
230 Participants
n=99 Participants
201 Participants
n=107 Participants
431 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=99 Participants
2 Participants
n=107 Participants
4 Participants
n=206 Participants
Region of Enrollment
United States
304 participants
n=99 Participants
256 participants
n=107 Participants
560 participants
n=206 Participants
Body Mass Index (BMI)
30.7 kg/m^2
STANDARD_DEVIATION 8.6 • n=99 Participants
31.5 kg/m^2
STANDARD_DEVIATION 9.9 • n=107 Participants
31.0 kg/m^2
STANDARD_DEVIATION 9.2 • n=206 Participants
ASA Physical Status
ASA 1
10 Participants
n=99 Participants
9 Participants
n=107 Participants
19 Participants
n=206 Participants
ASA Physical Status
ASA 2
157 Participants
n=99 Participants
127 Participants
n=107 Participants
284 Participants
n=206 Participants
ASA Physical Status
ASA 3
129 Participants
n=99 Participants
119 Participants
n=107 Participants
248 Participants
n=206 Participants
ASA Physical Status
ASA 4
8 Participants
n=99 Participants
1 Participants
n=107 Participants
9 Participants
n=206 Participants
ASA Physical Status
ASA 5
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants

PRIMARY outcome

Timeframe: up to 1 day

The difference in discharge readiness time between the observation and interaction phases will be compared

Outcome measures

Outcome measures
Measure
Observation Phase
n=304 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=256 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Difference in Time to PACU Discharge Determination From Observation to Interaction Phase
84.5 Minutes
Interval 54.0 to 116.5
91.5 Minutes
Interval 62.0 to 145.0

SECONDARY outcome

Timeframe: up to 1 day

Percent of patients the telemedicine center participated in the hand-off process from OR to the PACU in both the observation and interaction phases. Participation by the telemedicine center was successful if the telemedicine center could both remotely join the hand-off process and collect relevant patient care information.

Outcome measures

Outcome measures
Measure
Observation Phase
n=304 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=256 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Demonstrate the Potential Ability of a Remote Telemedicine Center for the PACU to Assist With PACU Functions.
Hand-off participation Yes
205 Participants
249 Participants
Demonstrate the Potential Ability of a Remote Telemedicine Center for the PACU to Assist With PACU Functions.
Hand-off participation No
99 Participants
7 Participants

SECONDARY outcome

Timeframe: approximately 1 day

The proportion of physiological derangements identified in the telemedicine center in both the observation and interaction phases

Outcome measures

Outcome measures
Measure
Observation Phase
n=304 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=256 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Detection of Physiological Derangements in PACU Patients
39 Participants
26 Participants

SECONDARY outcome

Timeframe: approximately 1 day

Number of patients identified with symptoms requiring treatment in PACU such as pain or nausea in both the observation and interaction phases

Outcome measures

Outcome measures
Measure
Observation Phase
n=304 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=256 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Identification of Symptoms Requiring Treatment in PACU Patients
72 Participants
94 Participants

SECONDARY outcome

Timeframe: approximately 1 day

The number of patients identified requiring emergency medical intervention in both the observation and interaction phases

Outcome measures

Outcome measures
Measure
Observation Phase
n=304 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=256 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Recognition of Situations Requiring Emergency Medical Intervention
2 Participants
3 Participants

SECONDARY outcome

Timeframe: approximately 1 day

Population: For cases where patients were discharged from the PACU during ePACU operational hours (M-F; 0700- 1600).

Number of patients determined to be ready for PACU discharge prior to documentation by the PACU Team in both the observation and interaction phases

Outcome measures

Outcome measures
Measure
Observation Phase
n=260 Participants
In the first three months of this proof-of-concept study, a telemedicine center for the PACU will monitor patients assigned to PACU bays. Both telemedicine center clinicians and nurses caring for patients in these PACU bays will independently record information on patient physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness (based on the modified Aldrete scale). During this phase of the study, clinicians in the telemedicine center will not communicate with clinicians in the PACU (nurses or physicians), unless there was a patient safety event.
Interaction Phase
n=204 Participants
In the three months following the observation phase, clinicians in the telemedicine center will interact with clinicians and patients in the two designated PACU bays using audio-visual technology. The clinicians in the telemedicine center will continue to document information on physiological derangements, treatable symptoms, situations requiring urgent medical intervention, and discharge readiness. Alertwatch - Interaction: Decision-support software, customized for the PACU environment, Interaction between the telemedicine center and the PACU
Determination of Patient Readiness for PACU Discharge
233 Participants
199 Participants

Adverse Events

Observation Phase

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Interaction Phase

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Thaddeus Budelier

Washington University School of Medicine

Phone: 314-273-8646

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place