RT Assistant - handheld patient safety tool for mechanical ventilation

PROJECT SUMMARY Respiratory Therapists (RTs) are increasingly tasked to improve the quality of care provided for their patients on mechanical ventilation while controlling cost amidst a high workload. Challenges for the RTs include maintaining continuous awareness of patient-ventilator interactions, assuring compliance with best practice protocols, and providing efficient communication during shift changes. While new technology has been recently introduced to improve medical record documentation, there is a scarcity of innovative electronic tools that can improve compliance with best practices and communications in respiratory care. In Phase I of the grant we successfully built and evaluated a fully-functional prototype system called RT Assistant that provides continuous remote monitoring of ventilated patients. The device provides real time management guidelines, guidance on patient safety and best clinical practices, and a standardized hand-off communication tool. The Phase I prototype was designed to evaluate the feasibility of the tool and its integration into an RT's workflow. Phase II effort will add functionality, improve data security, increase usability, and allow for customized user interfaces for each hospital or unit. The Phase II system will facilitate commercialization and will be tested in 3 clinical trials at 3 different hospitals. RT Assistant will serve as a platform for future modular upgrades that will provide clinical decision support (CDS) tailored for respiratory care. In Phase II, we propose two specific aims. Aim 1 – Productize the RT Assistant system To address usability and commercialization concerns, this aim will address three categories of improvements to RT Assistant. First, implement and validate appropriate data security and IT requirements in order to be allowed to operate safely in a healthcare environment. Second, increase functionality by adding an additional oxygenation CPG, support low acuity ventilation, and management features that support departmental quality assessment. Third, increase ease of use by allowing customization of the system for different hospitals and ICUs and enable use on different platforms. Aim 2 – Evaluate effectiveness of RT Assistant in multi-center clinical trial To evaluate the effectiveness of the system in different environments, we will evaluate the system in two ICUs from two different hospitals. Baseline data will be collected for 1 month and then data will be collected while RTs use the RT Assistant for 1 month. Statistical analyses of pre- and post-intervention data includes change in time patients are outside the CPGs, quality of shift reports, and RT satisfaction scores while using the system. After completion of this Phase II grant, we will have created a secure, inexpensive, intuitive, highly functional system proven to: increase compliance with CPGs, improve shift report communication, and enhance situational awareness, resulting in improved patient care and reduced medical errors. The clinical results will provide data that will enable early adopter sales for the RT Assistant system.