Table 3.
Nurse escalation of care of participants in virtual care and remote automated monitoring group*
| Total No of patients (n=451) | Patients in centres with highest escalation of care (n=177) | Patients in centres with intermediate escalation of care (n=189) | Patients in centres with lowest escalation of care (n=85) | P value | |
|---|---|---|---|---|---|
| No (%) of patients with escalation of care | 290 (64.3) | 158 (89.3) | 103 (54.5) | 29 (34.1) | <0.001 |
| Total No of escalations | 1041 | 758 | 227 | 56 | |
| Mean No of escalations per patient in virtual care group | 2.3 | 4.3 | 1.2 | 0.7 | |
| Trigger of escalation of care (No): | |||||
| Onset/change of sign or symptom | 481 | 353 | 86 | 42 | |
| Biophysical variable | 366 | 278 | 78 | 10 | |
| Drug issue | 152 | 98 | 50 | 4 | |
| Other | 42 | 29 | 13 | 0 | |
| Mean No of triggers of escalation of care per patient in virtual care group: | |||||
| Onset/change of sign or symptom | 1.1 | 2.0 | 0.5 | 0.5 | |
| Biophysical variable | 0.8 | 1.6 | 0.4 | 0.1 | |
| Drug issue | 0.3 | 0.6 | 0.3 | 0.1 | |
| Other | 0.1 | 0.2 | 0.1 | 0 | |
| No of escalations of care to study doctor† (No): | |||||
| Perioperative medicine doctor | 990 | 747 | 200 | 43 | |
| Surgeon | 55 | 29 | 22 | 4 | |
| Mean No of escalations of care to study doctor per patient in virtual care group: | |||||
| Perioperative medicine doctor | 2.2 | 4.2 | 1.1 | 0.5 | |
| Surgeon | 0.1 | 0.2 | 0.1 | 0.1 | |
| Result of escalation of care (No): | |||||
| Change in drug | 385 | 237 | 124 | 24 | |
| Virtual visit | 316 | 234 | 61 | 21 | |
| Continue to monitor with no immediate action | 329 | 295 | 31 | 3 | |
| Outpatient diagnostic testing‡ | 79 | 38 | 29 | 12 | |
| Nurse to educate patient§ | 73 | 67 | 4 | 2 | |
| Patient to follow-up with non-study doctor | 49 | 35 | 11 | 3 | |
| Other | 53 | 28 | 16 | 9 | |
| Mean results of escalation of care per patient in virtual care group: | |||||
| Change in drug | 0.9 | 1.3 | 0.7 | 0.3 | |
| Virtual visit | 0.7 | 1.3 | 0.3 | 0.3 | |
| Continue to monitor with no immediate action | 0.7 | 1.7 | 0.2 | <0.1 | |
| Outpatient diagnostic testing‡ | 0.2 | 0.2 | 0.2 | 0.1 | |
| Nurse to educate patient§ | 0.2 | 0.4 | <0.1 | <0.1 | |
| Patient to follow-up with non-study doctor | 0.1 | 0.2 | 0.1 | <0.1 | |
| Other | 0.1 | 0.2 | 0.1 | 0.1 |
*
Escalation of care to doctor per patient at centre.
†
Sums of perioperative medicine doctors and surgeons exceeds total number of patients as some patients had escalation of care to both.
‡
Outpatient diagnostic testing included blood and urine tests, imaging, and electrocardiography.
§
Nurses educated patient about, for example, drug dosing and monitoring wound.