Cook Matthew, Umoren Rachel, Steinlage Elizabeth, Rajivan Prashanth, Li Lun, Feltner John, Cham Andia Pouresfandiary, Sawyer Taylor
Department of Pediatrics.
Department of Industrial and Systems Engineering.
J Patient Saf. 2025 Oct 1;21(7Supp):S65-S71. doi: 10.1097/PTS.0000000000001402. Epub 2025 Aug 8.
To evaluate the impact of using a simulated teletransport application compared with ad hoc phone calls between medical control physicians (MCP) and transport teams on situational awareness and communication during neonatal interfacility transports.
In this pilot study, MCPs and pediatric critical care transport teams (PCCT) participated in simulated neonatal transports with or without a simulated transport monitoring and communication (T-MAC) application. Situational awareness (perception, the recognition of the patient's status; comprehension, the understanding of the significance of patient's status; and projection, anticipation of what the patient's status will likely become) and the overall duration of communication was measured and compared between and within groups.
Thirty-three subjects (20 MCP, 13 PCCT) participated in 52 simulations. MCPs had higher overall situational awareness scores with use of the T-MAC app compared with ad hoc phone calls with increased mean perception (98%, T-MAC versus 79%, no T-MAC, P = 0.003) and projection (53%, T-MAC versus 40%, no T-MAC, P = 0.004) scores before a patient event (sudden adverse change to patient status); and increased perception (83%, T-MAC versus 64%, no T-MAC, P = 0.03); comprehension (68%, T-MAC versus 48%, no T-MAC, P = 0.04); and projection (58%, T-MAC versus 30%, no T-MAC, P = 0001) scores after the event. PCCTs had higher mean perception (98%, T-MAC versus 81%, no T-MAC, P = 0.02) and projection (54%, T-MAC versus 45% no T-MAC) scores before the event. The median duration of call times decreased for adverse events (125, IQR: 45s, T-MAC versus 140, IQR: 70s, no T-MAC, P = 0.046).
In this simulated setting, the use of a specially designed teletransport app for neonatal interfacility transports improved situational awareness and increased the efficiency of communication for transport team stakeholders. There was greater benefit in improving situational awareness for the MCPs than for PCCT members. The development and use of a T-MAC application warrants further investigation.
评估在新生儿机构间转运过程中，与医疗控制医师（MCP）和转运团队之间的临时电话相比，使用模拟远程转运应用程序对态势感知和沟通的影响。
在这项前瞻性研究中，MCP和儿科重症监护转运团队（PCCT）参与了有或没有模拟转运监测与通信（T-MAC）应用程序的模拟新生儿转运。测量并比较了组间和组内的态势感知（感知，对患者状态的识别；理解，对患者状态重要性的理解；以及预测，对患者状态可能变化的预期）和沟通的总时长。
33名受试者（20名MCP，13名PCCT）参与了52次模拟。与临时电话相比，使用T-MAC应用程序时MCP的总体态势感知得分更高，在患者事件（患者状态突然出现不良变化）之前，平均感知得分增加（98%，T-MAC对79%，无T-MAC，P = 0.003），预测得分增加（53%，T-MAC对40%，无T-MAC，P = 0.004）；事件发生后，感知得分增加（83%，T-MAC对64%，无T-MAC，P = 0.03）；理解得分增加（68%，T-MAC对48%，无T-MAC，P = 0.04）；预测得分增加（58%，T-MAC对30%，无T-MAC，P = 0.001）。PCCT在事件发生前的平均感知得分（98%，T-MAC对81%，无T-MAC，P = 0.02）和预测得分（54%，T-MAC对45%，无T-MAC）更高。不良事件的通话时间中位数缩短（125，IQR：45秒，T-MAC对140，IQR：70秒，无T-MAC，P = 0.046）。
在这种模拟环境中，使用专门设计的用于新生儿机构间转运的远程转运应用程序可提高态势感知，并提高转运团队利益相关者的沟通效率。对MCP而言，在提高态势感知方面的益处比对PCCT成员更大。T-MAC应用程序的开发和使用值得进一步研究。
