Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved]
Introduction: Perioperative morbidity is a public health priority, and surgical volume is increasing rapidly. With advances in technology, there is an opportunity to research the utility of a telemedicine-based control center for anesthesia clinicians that assess risk, diagnoses negative patient tra...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2019-11-01
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| Series: | F1000Research |
| Online Access: | https://f1000research.com/articles/8-2032/v1 |
| _version_ | 1818174548074299392 |
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| author | Christopher R. King Joanna Abraham Thomas G. Kannampallil Bradley A. Fritz Arbi Ben Abdallah Yixin Chen Bernadette Henrichs Mary Politi Brian A. Torres Angela Mickle Thaddeus P. Budelier Sherry McKinnon Stephen Gregory Sachin Kheterpal Troy Wildes Michael S. Avidan TECTONICS Research Group |
| author_facet | Christopher R. King Joanna Abraham Thomas G. Kannampallil Bradley A. Fritz Arbi Ben Abdallah Yixin Chen Bernadette Henrichs Mary Politi Brian A. Torres Angela Mickle Thaddeus P. Budelier Sherry McKinnon Stephen Gregory Sachin Kheterpal Troy Wildes Michael S. Avidan TECTONICS Research Group |
| author_sort | Christopher R. King |
| collection | DOAJ |
| description | Introduction: Perioperative morbidity is a public health priority, and surgical volume is increasing rapidly. With advances in technology, there is an opportunity to research the utility of a telemedicine-based control center for anesthesia clinicians that assess risk, diagnoses negative patient trajectories, and implements evidence-based practices. Objectives: The primary objective of this trial is to determine whether an anesthesiology control tower (ACT) prevents clinically relevant adverse postoperative outcomes including 30-day mortality, delirium, respiratory failure, and acute kidney injury. Secondary objectives are to determine whether the ACT improves perioperative quality of care metrics including management of temperature, mean arterial pressure, mean airway pressure with mechanical ventilation, blood glucose, anesthetic concentration, antibiotic redosing, and efficient fresh gas flow. Methods and analysis: We are conducting a single center, randomized, controlled, phase 3 pragmatic clinical trial. A total of 58 operating rooms are randomized daily to receive support from the ACT or not. All adults (eighteen years and older) undergoing surgical procedures in these operating rooms are included and followed until 30 days after their surgery. Clinicians in operating rooms randomized to ACT support receive decision support from clinicians in the ACT. In operating rooms randomized to no intervention, the current standard of anesthesia care is delivered. The intention-to-treat principle will be followed for all analyses. Differences between groups will be presented with 99% confidence intervals; p-values <0.005 will be reported as providing compelling evidence, and p-values between 0.05 and 0.005 will be reported as providing suggestive evidence. Registration: TECTONICS is registered on ClinicalTrials.gov, NCT03923699; registered on 23 April 2019. |
| first_indexed | 2024-12-11T19:46:09Z |
| format | Article |
| id | doaj.art-68797c1a0a974b059725d656a915dc68 |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-12-11T19:46:09Z |
| publishDate | 2019-11-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-68797c1a0a974b059725d656a915dc682022-12-22T00:52:53ZengF1000 Research LtdF1000Research2046-14022019-11-01810.12688/f1000research.21016.123127Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved]Christopher R. King0Joanna Abraham1Thomas G. Kannampallil2Bradley A. Fritz3Arbi Ben Abdallah4Yixin Chen5Bernadette Henrichs6Mary Politi7Brian A. Torres8Angela Mickle9Thaddeus P. Budelier10Sherry McKinnon11Stephen Gregory12Sachin Kheterpal13Troy Wildes14Michael S. Avidan15TECTONICS Research GroupDepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Computer Science and Engineering, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Surgery, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, University of Michigan, Ann Arbor, MI, 48109, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USADepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, 63110, USAIntroduction: Perioperative morbidity is a public health priority, and surgical volume is increasing rapidly. With advances in technology, there is an opportunity to research the utility of a telemedicine-based control center for anesthesia clinicians that assess risk, diagnoses negative patient trajectories, and implements evidence-based practices. Objectives: The primary objective of this trial is to determine whether an anesthesiology control tower (ACT) prevents clinically relevant adverse postoperative outcomes including 30-day mortality, delirium, respiratory failure, and acute kidney injury. Secondary objectives are to determine whether the ACT improves perioperative quality of care metrics including management of temperature, mean arterial pressure, mean airway pressure with mechanical ventilation, blood glucose, anesthetic concentration, antibiotic redosing, and efficient fresh gas flow. Methods and analysis: We are conducting a single center, randomized, controlled, phase 3 pragmatic clinical trial. A total of 58 operating rooms are randomized daily to receive support from the ACT or not. All adults (eighteen years and older) undergoing surgical procedures in these operating rooms are included and followed until 30 days after their surgery. Clinicians in operating rooms randomized to ACT support receive decision support from clinicians in the ACT. In operating rooms randomized to no intervention, the current standard of anesthesia care is delivered. The intention-to-treat principle will be followed for all analyses. Differences between groups will be presented with 99% confidence intervals; p-values <0.005 will be reported as providing compelling evidence, and p-values between 0.05 and 0.005 will be reported as providing suggestive evidence. Registration: TECTONICS is registered on ClinicalTrials.gov, NCT03923699; registered on 23 April 2019.https://f1000research.com/articles/8-2032/v1 |
| spellingShingle | Christopher R. King Joanna Abraham Thomas G. Kannampallil Bradley A. Fritz Arbi Ben Abdallah Yixin Chen Bernadette Henrichs Mary Politi Brian A. Torres Angela Mickle Thaddeus P. Budelier Sherry McKinnon Stephen Gregory Sachin Kheterpal Troy Wildes Michael S. Avidan TECTONICS Research Group Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved] F1000Research |
| title | Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved] |
| title_full | Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved] |
| title_fullStr | Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved] |
| title_full_unstemmed | Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved] |
| title_short | Protocol for the Effectiveness of an Anesthesiology Control Tower System in Improving Perioperative Quality Metrics and Clinical Outcomes: the TECTONICS randomized, pragmatic trial [version 1; peer review: 2 approved] |
| title_sort | protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes the tectonics randomized pragmatic trial version 1 peer review 2 approved |
| url | https://f1000research.com/articles/8-2032/v1 |
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