Code Blue Outcomes & Process Improvement Through Leadership Optimization Using Teleintensivists-Simulation (COPILOT-Sim)

Intermountain Health Care, Inc.

Status: Completed

Conditions: Cardiac Arrest

Treatments: Other: Tele-intensivist consultation; Other: Simulated "observation" by ICU physician

Study type: Interventional

Funder types: Other

Identifiers

NCT03000829

1050317 (Other Identifier)

COPILOT-SIMULATION

Details and patient eligibility

About

This multicenter randomized trial will employ in-situ cardiac arrest simulations ("mock codes") to test whether using telemedicine technology to add an intensive care physician as the "copilot" for cardiac arrest resuscitation teams influences chest compression quality, resuscitation protocol adherence, team function, and provider experience.

Full description

Only 15-30% of patients who suffer in-hospital cardiac arrest (IHCA) survive to hospital discharge. Factors associated with lower mortality and improved function include provision of high-quality, minimally-interrupted chest compressions and swift defibrillation of eligible arrhythmias. Unfortunately, resuscitation teams provide suboptimal care to 25-40% of IHCA victims. A dedicated IHCA team "copilot" may improve resuscitation team performance by providing the team leader with parallel analysis, situational awareness augmentation, action checking, protocol verification, and error correction. Critical care physician involvement via a telemedicine link could allow experienced specialists to fill the "copilot" role in a cost and resource-efficient manner, particularly in smaller hospitals with fewer available physicians.

The current study will evaluate how consultation by an off-site intensive care physician via a telemedicine link influences local IHCA teams' quality of care, team function and provider experience during simulated cardiac arrest events ("mock codes").

Enrollment: 1,001 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria (on-site cardiac arrest team):

• Are 18 years of age or older

Inclusion criteria (teleintensivist cardiac arrest team copilot):

• Are 18 years of age or older
• Are a board-certified or board-eligible critical care physician
• Provide clinical care through the Intermountain Healthcare Telecritical Care program

Exclusion criteria (both groups):

• Are under 18 years of age
• Are a member of the study research team

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,001 participants in 2 patient groups, including a placebo group

Tele-intensivist consultation

Experimental group

Description:

Standardized consultation to on-site cardiac arrest response team by off-site intensivist via two-way audiovisual link using a mobile telemedicine cart

Treatment:

Other: Tele-intensivist consultation

Control

Placebo Comparator group

Description:

Simulated "observation" by ICU physician by displaying a silent, pre-recorded, non-interactive videotape of an ICU physician. The on-site participants will be told that an intensive care physician is observing the mock code.

Treatment:

Other: Simulated "observation" by ICU physician