Using Telehealth Support to Improve Coordination of Awakening and Breathing Trials for Patients on Mechanical Ventilation in the ICU

What this Trial Is About

This research aims to evaluate whether adding telehealth-enabled support to the usual audit and feedback process can improve adherence to coordinated spontaneous awakening and breathing trials C-SATSBT and patient outcomes in people who are mechanically ventilated. Sedation during mechanical ventilation helps comfort but prolonged use can increase risks such as pneumonia, delirium, and longer ventilation times. Coordinating daily sedation interruptions with breathing trials has shown benefits but is often underused due to implementation challenges. This trial compares usual audit and feedback alone versus combined with telehealth support to see which better improves adherence and clinical results. Participants will receive either the usual audit and feedback approach or the same approach plus telehealth-enabled support, which helps identify candidates for trials, prompts bedside providers, and guides trial execution in real time. The study is a cluster-randomized trial using these two groups to understand the impact of telehealth on implementing coordinated sedation and breathing trials. During the study, researchers will track adherence to the coordinated trials from intubation to extubation about 5 days and measure ventilator-free days over 28 days. Additional outcomes include mortality at 30 and 90 days, length of hospital and ICU stay, new ventilator-associated pneumonia, reintubation, and unintentional extubation. The study began in September 2022 and will continue through October 2026, with ongoing monitoring of patient outcomes during and after mechanical ventilation.

Telehealth-Enabled, Real-time Audit and Feedback for Clinician AdHerence (TEACH)