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Reconstructing Medical Practice
Published in Christine Jorm, Reconstructing Medical Practice, 2016
For example, let us consider a teamwork issue. Teamwork is not an automatic consequence of co-location and depends on willingness to cooperate for the sake of a shared goal (Amalberti et al. 2005). Health care has difficulties in setting and determining shared goals. Doctors and nurses frequently have different goals. Nursing focus is often on the series of tasks that deliver care, while doctors’ focus may be on diagnosis. It is sometimes possible to make the goal both better shared and defined. Intensivist Peter Pronovost was able to halve patient length of stay in an Intensive Care Unit at Johns Hopkins Hospital by introducing a patient goals checklist initialled by all care providers three times a day (Pronovost et al. 2003). The first question asked was the most important: ‘What needs to be done for the patient to be discharged from the ICU?’
A sociotechnical framework for integration of telehealth into clinical workflow
Published in IISE Transactions on Healthcare Systems Engineering, 2023
Samuel Bonet Olivencia, Farzan Sasangohar
Expert review of the framework consisted of two rounds of structured interviews, conducted virtually using Zoom and WebEx, with 17 professionals with telehealth experience. The first round included 11 clinicians or clinical personnel involved in the use, support, or maintenance of a virtual intensive care unit (vICU) platform to provide continuous intensivist coverage for acute patients in a hospital in the state of Texas. The participants in the first round included four virtual nurses (vRNs), three vICU and bedside managers and directors, one bedside registered nurse (RN), one physician (MD), one respiratory care coordinator, and one IT personnel. The second round included 6 stakeholders involved in the design, development, and management of telehealth interventions. Three of these stakeholders were founders and managers of a remote patient monitoring company in the state of Texas, which bridges patients to providers by facilitating telemonitoring services to patients with chronic conditions such as diabetes and hypertension. One of the participants was a clinical research assistant professor and director of a telebehavioral health intervention program. Another participant was a clinical research assistant professor and forensic nurse involved in the development of a telehealth sexual assault nurse examiner program. The last participant was a licensed psychologist in the state of Texas, with about 6.5 years of experience in providing counseling services using a virtual video visit telemedicine platform.