Nirit Putievsky Pilosof1, Michael Barrett2, Eivor Oborn3, Galia Barkai4,5,6, Itai M Pessach5,6,7, Eyal Zimlichman5,6,7. 1. Cambridge Digital Innovation-CJBS & Hughes Hall, 2152University of Cambridge, United Kingdom. 2. Cambridge Judge Business School (CJBS), 2152University of Cambridge, United Kingdom. 3. Warwick Business School, University of Warwick, United Kingdom. 4. Sheba BEYOND, 26744Sheba Medical Center, Tel Hashomer, Israel. 5. 26744Sheba Medical Center, Tel Hashomer, Israel. 6. Sackler Faculty of Medicine, Tel-Aviv University, Israel. 7. Sheba's Talpiot Medical Leadership Program, Israel.
Abstract
OBJECTIVE: This case study examines the implementation of inpatient telemedicine in COVID-19 intensive care units (ICUs) and explores the impact of shifting forms of visibility on the management of the unit, staff collaboration, and patient care. BACKGROUND: The COVID-19 crisis drove healthcare institutions to rapidly develop new models of care based on integrating digital technologies for remote care with transformations in the hospital-built environment. The Sheba Medical Center in Israel created COVID-19 ICUs in an underground structure with an open-ward layout and telemedicine control rooms to remotely supervise, communicate, and support the operations in the contaminated zones. One unit had a physical visual connection between the control room and the contaminated zone through a window, while the other had only a virtual connection with digital technologies. METHODS: The findings are based on semistructured interviews with Sheba medical staff, telemedicine companies, and the architectural design team and observations at the COVID-19 units during March-August 2020. RESULTS: The case study illustrates the implications of virtual and physical visibility on the management of the unit, staff collaboration, and patient care. It demonstrates the correlations between patterns of visibility and the users' sense of control, orientation in space, teamwork, safety, quality of care, and well-being. CONCLUSIONS: The case study demonstrates the limitations of current telemedicine technologies that were not designed for inpatient care to account for the spatial perception of the unit and the dynamic use of the space. It presents the potential of a hybrid model that balances virtual and physical forms of visibility and suggests directions for future research and development of inpatient telemedicine.
OBJECTIVE: This case study examines the implementation of inpatient telemedicine in COVID-19 intensive care units (ICUs) and explores the impact of shifting forms of visibility on the management of the unit, staff collaboration, and patient care. BACKGROUND: The COVID-19 crisis drove healthcare institutions to rapidly develop new models of care based on integrating digital technologies for remote care with transformations in the hospital-built environment. The Sheba Medical Center in Israel created COVID-19 ICUs in an underground structure with an open-ward layout and telemedicine control rooms to remotely supervise, communicate, and support the operations in the contaminated zones. One unit had a physical visual connection between the control room and the contaminated zone through a window, while the other had only a virtual connection with digital technologies. METHODS: The findings are based on semistructured interviews with Sheba medical staff, telemedicine companies, and the architectural design team and observations at the COVID-19 units during March-August 2020. RESULTS: The case study illustrates the implications of virtual and physical visibility on the management of the unit, staff collaboration, and patient care. It demonstrates the correlations between patterns of visibility and the users' sense of control, orientation in space, teamwork, safety, quality of care, and well-being. CONCLUSIONS: The case study demonstrates the limitations of current telemedicine technologies that were not designed for inpatient care to account for the spatial perception of the unit and the dynamic use of the space. It presents the potential of a hybrid model that balances virtual and physical forms of visibility and suggests directions for future research and development of inpatient telemedicine.
Entities:
Keywords:
COVID-19; control room; healthcare design; inpatient telemedicine; model of care; visibility
Authors: Stacie Vilendrer; Mary E Lough; Donn W Garvert; Monique H Lambert; Jonathan Hsijing Lu; Birju Patel; Nigam H Shah; Michelle Y Williams; Samantha M R Kling Journal: J Med Internet Res Date: 2022-06-17 Impact factor: 7.076
Authors: Nirit Putievsky Pilosof; Michael Barrett; Eivor Oborn; Galia Barkai; Itai M Pessach; Eyal Zimlichman Journal: Int J Environ Res Public Health Date: 2021-08-08 Impact factor: 3.390
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