Telehealth-Enabled, Real-time Audit and Feedback for Clinician AdHerence (TEACH)

Intermountain Health Care, Inc.

Status: Enrolling

Conditions: Respiration, Artificial

Treatments: Other: Usual audit and feedback for SAT/SBT adherence; Other: Telehealth- enabled support for SAT/SBT adherence

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05141396

1051681

U01HL159878 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

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.

Full 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.

Enrollment: 13,400 estimated patients

Sex: All

Ages: 16+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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13,400 participants in 2 patient groups

Intervention - Telehealth- enabled support plus usual audit and feedback for SAT/SBT adherence

Experimental group

Description:

Usual audit and feedback + telehealth-enabled support

Treatment:

Other: Telehealth- enabled support for SAT/SBT adherence

Other: Usual audit and feedback for SAT/SBT adherence

Control - Usual audit/feedback for SAT/SBT adherence only

Active Comparator group

Description:

Usual audit and feedback

Treatment:

Other: Usual audit and feedback for SAT/SBT adherence