Weiss Björn, Paul Nicolas, Kraufmann Ben, Spies Claudia D
Anasthesiol Intensivmed Notfallmed Schmerzther. 2021 Jan;56(1):41-51. doi: 10.1055/a-1130-4996. Epub 2021 Jan 7.
There is a high demand for critical care, which is forecasted to further grow in the future. Increasing patient morbidity and complexity concurring with a shortage of trained intensivists imposes challenges on critical care clinicians. Weathering these challenges, telemedical programs can help utilize and allocate resources more efficiently as well as foster adherence to best practice, thereby directly impacting quality of care. Studies have predominantly shown reductions in mortality and length of stay. Successful telemedical programs employ experienced intensivists, have well-functioning equipment and high acceptance among on-site clinicians. The multicenter, pragmatic, stepped wedge cluster-randomized controlled quality improvement trial Enhanced Recovery after Intensive Care (ERIC) pilots a new form of critical care provision in Germany. With a target study sample size of n = 1431 patients, the study aims to utilize telemedicine to increase adherence to a set of evidence- and consensus-based quality indicators for acute critical care. In an intersectoral case-care management, patients are followed three and six months after discharge from the intensive care unit to be assessed for long-term impairments and post-intensive care syndrome.
对重症监护的需求很高，预计未来还会进一步增长。患者发病率和病情复杂性的增加，加上训练有素的重症监护医生短缺，给重症监护临床医生带来了挑战。通过远程医疗项目应对这些挑战，可以帮助更有效地利用和分配资源，并促进对最佳实践的遵循，从而直接影响护理质量。研究主要表明死亡率和住院时间有所降低。成功的远程医疗项目需要有经验丰富的重症监护医生、运转良好的设备以及现场临床医生的高度认可。多中心、务实、阶梯式楔形整群随机对照质量改进试验“重症监护后强化康复”（ERIC）在德国试点了一种新的重症监护提供形式。该研究的目标样本量为n = 1431名患者，旨在利用远程医疗提高对一组基于证据和共识的急性重症监护质量指标的遵循程度。在跨部门病例护理管理中，患者在重症监护病房出院后3个月和6个月接受随访，以评估长期损伤和重症监护后综合征。
