2545 Clemson University, South Carolina, USA.
33319 Air Force Research Lab, Wright Patterson Air Force Base in Dayton, Ohio, USA.
Hum Factors. 2022 Feb;64(1):21-41. doi: 10.1177/0018720821995687. Epub 2021 Mar 3.
The purpose of this study is to understand the communication among care teams during telemedicine-enabled stroke consults in an ambulance.
Telemedicine can have a significant impact on acute stroke care by enabling timely intervention in an ambulance before a patient reaches the hospital. However, limited research has been conducted on understanding and supporting team communication during the care delivery process for telemedicine-enabled stroke care in an ambulance.
Video recordings of 13 simulated stroke telemedicine consults conducted in an ambulance were coded to document the tasks, communication events, and flow disruptions during the telemedicine-enabled stroke care delivery process.
The majority (82%) of all team interactions in telemedicine-enabled stroke care involved verbal interactions among team members. The neurologist, patient, and paramedic were almost equally involved in team interactions during stroke care, though the neurologist initiated 48% of all verbal interactions. Disruptions were observed in 8% of interactions, and communication-related issues contributed to 44%, with interruptions and environmental hazards being other reasons for disruptions in interactions during telemedicine-enabled stroke care.
Successful telemedicine-enabled stroke care involves supporting both verbal and nonverbal communication among all team members using video and audio systems to provide effective coverage of the patient for the clinicians as well as vice versa.
This study provides a deeper understanding of team interactions during telemedicine-enabled stroke care that is essential for designing effective systems to support teamwork.
本研究旨在了解救护车中远程医疗支持下的卒中咨询中护理团队之间的沟通。
远程医疗可以通过在患者到达医院之前在救护车上进行及时干预，对急性卒中护理产生重大影响。然而，对于理解和支持救护车中远程医疗支持下的卒中护理的团队沟通，相关研究仍十分有限。
对在救护车中进行的 13 次模拟卒中远程医疗咨询的视频记录进行编码，以记录远程医疗卒中护理提供过程中的任务、沟通事件和流程中断情况。
在远程医疗卒中护理中，大多数（82%）团队交互都涉及团队成员之间的口头交互。在卒中护理过程中，神经科医生、患者和护理人员几乎平等地参与团队交互，尽管神经科医生发起了 48%的口头交互。在 8%的交互中观察到了中断，而沟通相关问题占 44%，中断和环境危害是远程医疗支持下卒中护理交互中断的其他原因。
成功的远程医疗支持下的卒中护理需要使用视频和音频系统支持所有团队成员之间的口头和非口头沟通，以便为临床医生有效覆盖患者，反之亦然。
本研究深入了解了远程医疗支持下的卒中护理中的团队交互，这对于设计有效的团队支持系统至关重要。
