Telehealth-Enabled, Real-time Audit and Feedback for Clinician AdHerence (TEACH)
Purpose
The purpose of this trial is to evaluate if augmenting a usual audit and feedback implementation approach with telehealth-enabled support improves coordinated spontaneous awakening/breathing trials and patient outcomes for mechanically ventilated patients.
Condition
- Respiration, Artificial
Eligibility
- Eligible Ages
- Over 16 Years
- Eligible Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Patient age >=16 years admitted to study hospital ICU - Intubated and mechanically ventilated
Exclusion Criteria
- Patient with pre-existing brain death admitted to study hospital for organ donation - Died within 24 hours of intubation
Study Design
- Phase
- N/A
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Health Services Research
- Masking
- None (Open Label)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Intervention - Telehealth- enabled support plus usual audit and feedback for SAT/SBT adherence |
Usual audit and feedback + telehealth-enabled support |
|
|
Active Comparator Control - Usual audit/feedback for SAT/SBT adherence only |
Usual audit and feedback |
|
Recruiting Locations
American Fork, Utah 84003
David Guidry, MD
Cedar City, Utah 84721
David Guidry, MD
Layton, Utah 84041
David Guidry, MD
Logan, Utah 84341
David Guidry, MD
Murray, Utah 84107
Ogden, Utah 84403
Colin Grissom, MD
Provo, Utah 84604
Colin Grissom, MD
Riverton, Utah 84065
David Guidry, MD
Salt Lake City, Utah 84143
Colin Grissom, MD
Sandy City, Utah 84094
David Guidry, MD
St. George, Utah 84790
Colin Grissom, MD
More Details
- NCT ID
- NCT05141396
- Status
- Recruiting
- Sponsor
- Intermountain Health Care, Inc.
Detailed Description
Sedation and analgesia are utilized with invasive mechanical ventilation (IMV) to improve patient comfort and synchrony with the mechanical ventilator. Prolonged sedation, however, may result in increased time on IMV and increased risk for ventilator associated pneumonia, delirium, and poor long-term cognitive outcomes. Daily interruptions in sedation [spontaneous awakening trials (SAT)] coordinated with daily spontaneous breathing trials (SBT) reduce mortality, increase ventilator free days, decrease intensive care unit (ICU) length of stay, and reduces ventilator-associated events. Coordination of spontaneous awakening and breathing trials (C-SAT/SBT), however, are underutilized due to significant barriers to implementation and adherence. This cluster-randomized hybrid implementation/effectiveness trial will compare C-SAT/SBT adherence and clinical outcomes in the presence of traditional audit and feedback implementation strategies alone or augmented with a novel Telehealth-Enabled, real-time Audit and feedback for Clinician adHerence ("TEACH") implementation strategy.