Virtual leadership in covid-19 ED: learning from perceptual gaps in knowledge and confidence to boost team performance using telemedicine

Mossad, Timothy

The Covid-19 pandemic poses challenges. Telemedicine is a recognised ICT tool we adopted for ‘rounding’ (frequent review of each patient) in our Emergency Department (ED) ‘hot area’. Virtual command and control leadership balanced infection control and risk assessment issues. This retrospective survey, power 8% at 95% confidence intervals, aimed to identify staff perceptions of using telemedicine. 103 colleagues (59 females, 44 males) participated in questionnaire completion over a designated one-week period after governance approval. Demographic data was collated on job title/band, sex, age bracket and whether the respondent had worked in the hot area (n=95) or not (n=8).Likert scale referenced statements on knowledge, confidence, safety and utility of telemedicine were transcribed into metric data for analysis (1-strongly disagree, 2-partially disagree, 3-neither agree/disagree, 4-partially agree, 5-strongly agree). Participants reflected the workforce proportionately. Respondents believed that telemedicine is useful, effective and appropriate in the context of their job role and function in Hot ED (3.62–4.36, p<0.001). Colleagues recognised telemedicine can assist team performance (3.93, p<0.001). Knowledge to use remote video conferencing verses telephone rounding increased confidence (p<0.01). Staff recognised initial perceptions to prefer physical senior presence (3.97, p<0.01). Perceptions on safety were neutral (3.07, p<0.001). Written feedback evidenced ownership and empowerment with progressive familiarisation. Self-recognition, staff acceptance and participation in adopting cultural leadership shifts were evident. Subgroup analysis evidenced facilitation of educational needs (n=36, 35%, p<0.0001) and portfolio requirements (n=11, 11%, p<0.01). Overall, perceptions to using telemedicine as an adjunct tool to rounding in Hot ED were positive. This survey provides a transferable valid platform for developing and exploring future balanced use of telemedicine.