Objective

The purpose of this study is to understand the communication among care teams during telemedicine-enabled stroke consults in an ambulance.

Background

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.

Method

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.

Results

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.

Conclusion

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.

Application

This study provides a deeper understanding of team interactions during telemedicine-enabled stroke care that is essential for designing effective systems to support teamwork.

中文翻译：

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救护车中远程医疗中风护理期间的沟通和团队合作

客观的

本研究的目的是了解在救护车上进行远程医疗中风咨询期间护理团队之间的沟通。

背景

远程医疗可以在患者到达医院之前及时对救护车进行干预，从而对急性中风护理产生重大影响。然而，在救护车中进行远程医疗中风护理的护理过程中，关于理解和支持团队沟通的研究有限。

方法

对在救护车上进行的 13 次模拟中风远程医疗咨询的视频进行编码，以记录支持远程医疗的中风护理提供过程中的任务、通信事件和流程中断。

结果

在支持远程医疗的中风护理中，大多数（82%）的团队互动涉及团队成员之间的口头互动。在中风护理期间，神经科医生、患者和护理人员几乎同样参与团队互动，尽管神经科医生发起了所有言语互动的 48%。在 8% 的互动中观察到中断，其中与沟通相关的问题占 44%，中断和环境危害是远程医疗中风护理期间互动中断的其他原因。

结论

成功的远程医疗中风护理涉及使用视频和音频系统支持所有团队成员之间的口头和非语言沟通，为临床医生提供有效的患者覆盖，反之亦然。

应用

这项研究提供了对远程医疗中风护理期间团队互动的更深入的了解，这对于设计有效的系统来支持团队合作至关重要。