An exploratory study investigating the barriers, facilitators, and demands affecting caregivers in a telemedicine integrated ambulance-based setting for stroke care

Telemedicine implementation in ambulances can reduce time to treatment for stroke patients, which is important as “time is brain” for these patients. Limited research has explored the demands placed on acute stroke caregivers in a telemedicine-integrated ambulance system. This study investigates the...

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Bibliographic Details
Published in:Applied ergonomics 2021-11, Vol.97, p.103537-103537, Article 103537
Main Authors: Rogers, Hunter, Madathil, Kapil Chalil, Joseph, Anjali, Holmstedt, Christine, Qanungo, Suparna, McNeese, Nathan, Morris, Tara, Holden, Richard J., McElligott, James T.
Format: Article
Language:English
Subjects:
Qualitative interviews
Stroke caregiving
Teamwork
Telemedicine
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Summary:Telemedicine implementation in ambulances can reduce time to treatment for stroke patients, which is important as “time is brain” for these patients. Limited research has explored the demands placed on acute stroke caregivers in a telemedicine-integrated ambulance system. This study investigates the impact of telemedicine on workload, teamwork, workflow, and communication of geographically distributed caregivers delivering stroke care in ambulance-based telemedicine and usability of the system. Simulated stroke sessions were conducted with 27 caregivers, who subsequently completed a survey measuring workload, usability, and teamwork. Follow-up interviews with each caregiver ascertained how telemedicine affected workflow and demands which were analyzed for barriers and facilitators to using telemedicine. Caregivers experienced moderate workload and rated team effectiveness and usability high. Barriers included frustration with equipment and with the training of caregivers increasing demands, the loss of personal connection of the neurologists with the patients, and physical constraints in the ambulance. Facilitators were more common with live visual communication increasing teamwork and efficiency, the ease of access to neurologist, increased flexibility, and high overall satisfaction and usability. Future research should focus on eliminating these barriers and supporting the distributed cognition of caregivers. •Workload in stroke caregiving does not vary by role.•Usability of REACH telemedicine system currently in use rated highly.•Team Effectiveness is rated highly, nurses rated teamwork higher than others.•Some facilitators were improved teamwork, access to specialist, patient care.•Barriers less common, included technical difficulties and experience of assistant.
ISSN:0003-6870
1872-9126
DOI:10.1016/j.apergo.2021.103537