Browsing by Author "Bensink, Mark E"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- ItemThe effectiveness of telemedicine for paediatric retrieval consultations: rationale and study design for a pragmatic multicentre randomised controlled trial.(2014-11-10) Armfield, Nigel R; Coulthard, Mark G; Slater, Anthony; McEniery, Julie; Elcock, Mark; Ware, Robert S; Scuffham, Paul A; Bensink, Mark E; Smith, Anthony CBackgroundIn many health systems specialist services for critically ill children are typically regionalised or centralised Studies have shown that high risk paediatric patients have improved survival when managed in specialist centres and that volume of cases is a predictor of care quality In acute cases where distance and time impede access to specialist care clinical advice may be provided remotely by telephone Emergency retrieval services attended by medical and nursing staff may be used to transport patients to specialist centres Even with the best quality retrieval services stabilisation of the patient and transport logistics may delay evacuation to definitive care Several studies have examined the use of telemedicine for providing specialist consultations for critically ill children However no studies have yet formally examined the clinical effectiveness and economic implications of using telemedicine in the context of paediatric patient retrieval Methods DesignThe study is a pragmatic multicentre randomised controlled trial running over 24 months which will compare the use of telemedicine with the use of the telephone for paediatric retrieval consultations between four referring hospitals and a tertiary paediatric intensive care unit We aim to recruit 160 children for whom a specialist retrieval consultation is required The primary outcome measure is stabilisation time time spent on site at the referring hospital by the retrieval team adjusted for initial risk Secondary outcome measures are change in patient s physiological status repeated measure two time points scored using the Children s Emergency Warning Tool change in diagnosis repeated measure taken at three time points change in destination of retrieved patients at the tertiary hospital general ward or paediatric intensive care unit retrieval decision and length of stay in the Paediatric Intensive Care Unit for retrieved patients The trial has been approved by the Human Research Ethics Committees of Children s Health Services Queensland and The University of Queensland Australia DiscussionHealth services are adopting telemedicine however formal evidence to support its use in paediatric acute care is limited Generalisable evidence is required to inform clinical use and health system policy relating to the effectiveness and economic implications of the use in telemedicine in paediatric retrieval Trial registrationAustralian and New Zealand Clinical Trials Registry ACTRN12612000156886
- ItemHome telemedicine for paediatric palliative care.(2010-12-30) Bradford, Natalie; Herbert, Anthony; Walker, Rick; Pedersen, Lee-Anne; Hallahan, Andrew; Irving, Helen; Bensink, Mark E; Armfield, Nigel R; Smith, Anthony CChildren with life limiting conditions require intensive complex management of the physical psychosocial and spiritual issues that evolve for the child and their family as the focus of care moves from curative treatment to palliation Optimal palliative care for children can be limited by the lack of health professionals with the necessary skills and experience to confidently and competently manage the care of both the child and the family The University of Queensland s Centre for Online Health has been working closely with the Paediatric Palliative Care Service PPCS at the Royal Children s Hospital RCH in Brisbane Australia to investigate the potential of telemedicine for the delivery of specialist support in the home or local community Research conducted in Queensland has shown how telemedicine can be effectively used to link the specialist paediatric palliative care team into the home of families caring for a child receiving palliative care regardless of their physical distance from the RCH This qualitative report describes two case studies each illustrating the value of home telemedicine for families at this vulnerable and distressing time This work should provide a useful insight for other specialty disciplines contemplating home telemedicine applications