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Best Practices in Telecritical Care: Expert Consensus Recommendations From the Telecritical Care Collaborative

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Telecritical care (TCC) experts developed 78 consensus statements on best practices for TCC delivery. These recommendations emphasize expert teams, clear protocols, and tailored interventions for high-quality remote critical care.

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Area of Science:

  • Critical Care Medicine
  • Telehealth
  • Health Services Research

Background:

  • Telecritical care (TCC) is growing, but lacks standardized practices and research on its effectiveness.
  • Significant variation exists in TCC implementation and delivery models.
  • There is a need for expert consensus on best practices for TCC.

Purpose of the Study:

  • To establish expert, consensus-based best practice recommendations for the design and delivery of TCC.
  • To address the practice variation and sparse literature in TCC.
  • To provide a foundation for high-quality TCC programs.

Main Methods:

  • A modified Delphi methodology was employed, involving literature review and multiple voting rounds.
  • An oversight panel of 18 multidisciplinary experts and a voting panel of 32 TCC experts participated.
  • Consensus was defined as agreement by ≥85% of voting panel members.

Main Results:

  • Ten core domains of TCC were identified, leading to 79 practice statements.
  • 78 out of 79 statements achieved expert consensus after three rounds of review and revision.
  • Key domains included care delivery models, staffing, technology, quality, and safety.

Conclusions:

  • Expert consensus was reached on 78 practice statements for TCC delivery.
  • TCC is most effective with expert teams, explicit protocols, and focus on communication, reliability, and availability.
  • Recommendations emphasize tailoring interventions to local conditions and highlight the need for further research.