WIP 76 - The Effect of Telemedicine on Neonatal Stabilization: A Simulation-Based Study

Publication Number: WIP 76.7625

Leida Voulgaropoulos, Georgetown University School of Medicine, Washington, DC, United States; Jane Germano, MedStar Washington Hospital Center, Waashington, DC, United States; Deborah A. Hoy, Georgetown University School of Medicine, Fort Washington, MD, United States

Background: Effective pre-transport stabilization is critical to optimize short and long-term outcomes for neonates. Challenges at referring hospitals include access to specialized expertise, comfort with necessary assessments and interventions, and team dynamics. Telemedicine may improve patient outcomes by bridging the gap between the referring and accepting providers.

Objective: The primary objective of this study is to evaluate the effect of video telemedicine on time to infant stabilization and efficacy of stabilization as compared to phone consult.

Design/Methods: This is a pre-post, simulation-based pilot study. The study received approval from the Medstar Georgetown University IRB. Pediatricians working at Level 1 or 2 NICUs, and neonatology fellows were recruited to participate. Pediatricians participated in two distinct neonatal stabilization simulations of equal complexity. In the first, pediatricians could access a remote neonatology fellow via voice-only telephone consult (control). In the second, a remote neonatology fellow participated via a video telemedicine consult (intervention). Simulations were video recorded and evaluated for adherence to a standardized checklist and for three critical time points: time to intubation, time to a consult, and time to stabilization. Teamwork and workload were assessed using the Clinical Teamwork Scale and NASA-TLX, respectively. A convenience sample was used and included ten pediatricians and eight neonatology fellows. This study is currently in progress with planned completion of data collection and statistical analyses by early 2025. Demographic variables will be assessed using descriptive statistics. Paired t-tests will be used to analyze normal continuous data, and Pearson’s chi-squared or Fischer’s exact tests will be used to analyze categorical data. We expect to determine if the use of video telemedicine increases the efficacy of stabilization and decreases the mean time to stabilization, which may inform future policies and procedures for its implementation.