A dynamic customized electronic health record rule based clinical decision support tool for standardized adult intensive care metrics.

Objectives: Many routine patient care items should be reviewed at least daily for intensive care unit (ICU) patients. These items are often incompletely performed, and dynamic clinical decision support tools (CDSTs) may improve attention to these daily items. We sought to evaluate the accuracy of institutionalized electronic health record (EHR) based custom dynamic CDST to support 22 ICU rounding quality metrics across 7 categories (hypoglycemia, venothromboembolism prophylaxis, stress ulcer prophylaxis, mechanical ventilation, sedation, nutrition, and catheter removal).

Application of Machine Learning Models to Biomedical and Information System Signals From Critically Ill Adults.

Background: Machine learning (ML)-derived notifications for impending episodes of hemodynamic instability and respiratory failure events are interesting because they can alert physicians in time to intervene before these complications occur.

Research Question: Do ML alerts, telemedicine system (TS)-generated alerts, or biomedical monitors (BMs) have superior performance for predicting episodes of intubation or administration of vasopressors?

Study Design And Methods: An ML algorithm was trained to predict intubation and vasopressor initiation events among critically ill adults. Its performance was compared with BM alarms and TS alerts.

COVID-19 and the Transformation of Intensive Care Unit Telemedicine.

The concept of telecritical care has evolved over several decades. ICU Telemedicine providers using both the hub-and-spoke ICU telemedicine center and consultative service delivery models offered their services during the COVID-19 pandemic. Telemedicine center responses were more efficient, timely, and widely used than those of the consultative model.

Describing advanced practice provider roles within critical care teams with Tele-ICUs: Exemplars from seven US health systems.

Telehealth is an acknowledged strategy to meet patient healthcare needs. In critical care settings, Tele-ICU's are expanding to deliver clinical services across a diverse spectrum of critically ill patients. The expansion of telehealth provides increased opportunities for advanced practice providers including advanced practice nurses and physician assistants; however, limited information on roles and models of care for advanced practice providers in telehealth exist.

Battling Intensivist Burnout: A Role for Workload Management.

Burnout syndrome is an increasingly common phenomenon that threatens our critical care workforce and the well-being of its members. Burnout syndrome can be conceived of as a workforce manifestation of chronic workload and workforce capacity imbalance. This study explores the role of workload management tools that can address workload as a complement to the resilience-based countermeasures that seek to increase worker capacity.