Telemedicine Control Tower for the Operating Room: Navigating Information, Care and Safety (TECTONICS)

The Washington University

Status and phase: Completed; Phase 3

Conditions: Perioperative/Postoperative Complications; Surgery; Surgery--Complications

Treatments: Device: Anesthesia Control Tower monitoring

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03923699

R01NR017916 (U.S. NIH Grant/Contract)

201903026

Details and patient eligibility

About

Medical errors account for thousands of potentially preventable deaths each year. With the annual increase of surgical cases there is a need for research into the potential utility of a telemedicine-based control center for the operating room to assess risk, diagnose negative patient trajectories, implement evidence-based practices, and improve outcomes.

Full description

This will be a single center, randomized, controlled, phase 3 pragmatic clinical trial. Forty-eight operating rooms will be randomized daily to receive support from the ACT or not. All adults (eighteen years and older) undergoing surgical procedures in these operating rooms will be included and followed until 30-days after their surgery. Clinicians in operating rooms randomized to 'intervention' will receive decision support from clinicians in the ACT. In operating rooms not randomized to receive decision support from the ACT, the current standard of anesthesia care will be delivered. The intention-to-treat principle will be followed for all analyses.

Enrollment: 79,560 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients 18 years or older undergoing surgery at Barnes Jewish Hospital in St. Louis, MO

Exclusion criteria

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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79,560 participants in 2 patient groups

Standard of care arm

No Intervention group

Description:

Operating rooms in the standard of care group will be monitored but, the ACT clinicians will not contact the operating room unless it is clinically necessary for patient safety purposes.

Anesthesia Control Tower monitoring

Experimental group

Description:

Clinicians in the Anesthesiology Control Tower will provide extra support for the anesthesiology team in the operating room using AlertWatch and integrating machine-learning forecasting algorithms for adverse outcomes.

Treatment:

Device: Anesthesia Control Tower monitoring