Robot-assisted surgical ward rounds: virtually always there

Publication Type:

Journal Article

Source:

Journal of Innovation in Health Informatics, Volume 25, Issue 1, p.42-56 (2018)

Keywords:

inpatient, novel, patient acceptability, robot, surgical care, telecommunication, telepresence, ward rounds

Abstract:

Background: While an explosion in technological sophistication has revolutionised surgery within the operating threatre, delivery of surgical ward-based care has seen little innovation. Use of telepresence allowing offsite clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive and static devices. We designed a prospective study ascertaining feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients. This device is, uniquely, lightweight, freely mobile and emulates 'human' interaction by swiveling and adjusting height to patients' eye-level.

Methods: Robot-assisted ward rounds (RASWRs) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRobotics, Burlingame, CA). Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs. The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as a control group. Data were paired and non-parametric analysis was performed.

Results: RASWRs are feasible (> 90% completed without technical difficulty). The RASWR (n=52 observations) demonstrated face validity with strong correlations (r>0.7; Spearman, p-value < 0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality.communication/satisfaction with management plan. Patients (96.08%, n=25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/non-consultant hospital doctor cohort [100% (n=11) willing to regularly partake in RASWR].

Conclusion: RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be physically present.