Journal of Robotic Surgery

, Volume 9, Issue 1, pp 51–56 | Cite as

The effect of robotic telerounding in the surgical intensive care units impact on medical education

  • Corrado Paolo Marini
  • Garry Ritter
  • Cordelia Sharma
  • John McNelis
  • Michael Goldberg
  • Rafael Barrera
Original Article

Abstract

Robotic telerounding is effective from the standpoint of patients’ satisfaction and patients’ care in teaching and community hospitals. However, the impact of robotic telerounding by the intensivist rounding remotely in the surgical intensive care unit (SICU), on patients’ outcome and on the education of medical students physician assistants and surgical residents, as well as on nurses’ satisfaction has not been studied. Prospective evaluation of robotic telerounding (RT) using a Likert Scale measuring tool to assess whether it can replace conventional rounding (CR) from the standpoint of patients’ care and outcome, nursing satisfaction, and educational effectiveness. RT did not have a negative impact on patients’ outcome during the study interval: mortality 5/42 (12 %) versus 6/37 (16 %), RT versus CR, respectively, p = 0.747. The intensivists rounding in the SICU were satisfied with their ability to deliver the same patients’ care remotely (Likert score 4.4 ± 0.2). The educational experience of medical students, physicia assistants, and surgical residents was not affected by RT (average Likert score 4.5 ± 0.2, 3.9 ± 0.4, and 4.4 ± 0.4 for surgical residents, medical students and PAs, respectively, p > 0.05). However, as shown by a Likert score of 3.5 ± 1.0, RT did not meet nurses’ expectations from several standpoints. Intensivists regard robotic telerounding as an effective alternative to conventional rounding from the standpoint of patients’ care and teaching. Medical students, physician assistants (PA’s), and surgical residents do not believe that RT compromises their education. Despite similar patients’ outcome, nurses have a less favorable opinion of RT; they believe that the physical presence of the intensivist is favorable at all times.

Keywords

Robot Telerounding SICU Medical education Outcome 

Notes

Conflict of interest

Corrado P Marini, MD, has no conflicts of interest to disclose. Garry Ritter PA has no conflicts of interest to disclose. Cordelia Sharma, MD, has no conflicts of interest to disclose. John McNelis, MD, has no conflicts of interest to disclose. Mr. Michael Goldberg has no conflicts of interest to disclose. Rafael Barrera, MD, has no conflicts of interest to disclose.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Supplementary material

11701_2014_489_MOESM1_ESM.jpg (268 kb)
Supplementary material 1 (JPEG 267 kb)

References

  1. 1.
    Ellison LM, Pinto PA, Kim F et al (2004) Telerounding and patient satisfaction after surgery. J Am Coll Surg 199:523–530CrossRefPubMedGoogle Scholar
  2. 2.
    Ellison LM, Nguyen M, Fabrizio MD et al (2007) Postoperative robotic telerounding: a multicenter randomized assessment of patient outcomes and satisfaction. Arch Surg 142:1177–1181CrossRefPubMedGoogle Scholar
  3. 3.
    Petelin JB, Goodman NJ (2007) Deployment and early experience with remote-presence patient care in a community hospital. Surg Endosc 21:53–56CrossRefPubMedGoogle Scholar
  4. 4.
    Gandsas A, Parekh M, Bleech MM, Tong DA (2009) Robotic telepresence: profit analysis in reducing length of stay after laparoscopic gastric bypass. J Am Coll Surg 205:72–77CrossRefGoogle Scholar
  5. 5.
    Vespa PM, Miller C, Hu X et al (2007) Intensive care unit robotic telepresence facilitates rapid physician response to unstable patients and decreased cost in neurointensive care. Surg Neurol 67:331–337CrossRefPubMedGoogle Scholar
  6. 6.
    Bauer JC, Ringel MA (1999) Telemedicine and the reinvention of health care: the seventh revolution in medicine. McGraw-Hill, New York, p 85Google Scholar
  7. 7.
    Rogers FB, Ricci M, Caputo M et al (2001) The use of telemedicine for real-time video consultation between trauma center and community hospital in a rural setting improves early trauma care: preliminary results. J Trauma 51:1037–1041CrossRefPubMedGoogle Scholar
  8. 8.
    Ries M (2009) Tele-ICU: a new paradigm in critical care. Int Anesthesiolog Clin 47:153–170CrossRefGoogle Scholar
  9. 9.
    Wootton R (2006) Realtime telemedicine. J Telemed Telecare 12:328–336CrossRefPubMedGoogle Scholar
  10. 10.
    Breslow MJ (2000) ICU telemedicine. Organization and communication. Crit Care Clin 16:707–720CrossRefPubMedGoogle Scholar
  11. 11.
    Celi LA, Hassan E, Marquardt C et al (2001) The eICU: it is not just telemedicine. Crit Care Med (Suppl N):183–189Google Scholar
  12. 12.
    Rosenfeld BA, Dorman T, Breslow MJ et al (2000) Intensive care unit telemedicine: alternate paradigm for providing continuous intensivist care. Crit Care Med 28:3925–3931CrossRefPubMedGoogle Scholar
  13. 13.
    Thacker PD (2005) Physician-robot makes the rounds. JAMA 293(2):150CrossRefPubMedGoogle Scholar
  14. 14.
    Sucher JF, Todd SR, Jones SL et al (2011) Robotic telepresence: a helpful adjunct that is viewed favorably by critically ill surgical patients. Am J Surg 202:843–847CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Corrado Paolo Marini
    • 1
  • Garry Ritter
    • 2
  • Cordelia Sharma
    • 1
  • John McNelis
    • 3
  • Michael Goldberg
    • 2
  • Rafael Barrera
    • 2
  1. 1.Department of SurgeryWestchester Medical Center University HospitalValhallaUSA
  2. 2.Long Island Jewish Medical CenterNew Hyde ParkUSA
  3. 3.Department of SurgeryNorth Bronx Network Jacobi Medical Center Central Bronx HospitalBronxUSA

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