A Qualitative Analysis of Shift Handoff Communication Practices Among Tele-ICU Clinicians

PURPOSE OF STUDY: The research study aimed to explore the Tele-ICU clinician's perception about the experience with shift handoff communication (SHC) and to identify the Tele-ICU clinician's challenges during the SHC experience. PRIMARY PRACTICE SETTING: Tele-ICU center in the Midwest region of the United States. METHODOLOGY AND SAMPLE: A phenomenological interpretive study was conducted to explore lived experiences of Tele-ICU intensivists during SHC. RESULTS: Five themes emerged in the research. The following are the themes: variabilities in SHC, discrepancies in information delivered during SHC, preference for standardized SHC, positive and negative attitudes toward SHC, and presence of barriers with SHC. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: In the Tele-ICU environment, the intensive care unit (ICU) provider also serves as the care coordinator since care is delivered remotely. At the Tele-ICU center, there was no clear indication that case managers were involved during the night shift in coordinating care, which needed further investigation and understanding. Even in a Tele-ICU environment, concise and impactful communication between the members of the multidisciplinary health care team is crucial. Therefore, there is a need to delineate the role of ICU providers as care coordinators remotely in terms of SHC. Information on how equipped the Tele-ICU providers are in terms of coordinating care in transitioning patients out of the Tele-ICU is limited compared to traditional bedside care where a case manager is available as a member of the multidisciplinary team.