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Testing Pediatric Emergency Telemedicine Implementation Strategies Using Quality Improvement Methods.

Jennifer L Rosenthal1, Hadley S Sauers-Ford1, Moina Snyder2

  • 1Department of Pediatrics, University of California at Davis, Sacramento, California, USA.

Telemedicine Journal and E-Health : the Official Journal of the American Telemedicine Association
|June 26, 2020
PubMed
Summary
This summary is machine-generated.

Quality improvement methods successfully increased telemedicine use for pediatric emergency consultations from 5% to 22%. This approach effectively tested implementation strategies without increasing consultation times.

Keywords:
childcommunicationemergency servicehealth care transitionshospitalhospitalspatient transferspediatricquality improvementreferral and consultationtelemedicine

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Area of Science:

  • Pediatric Emergency Medicine
  • Health Services Research
  • Telemedicine Implementation

Background:

  • Telemedicine offers benefits for pediatric emergency consultations but faces adoption barriers.
  • Quality improvement (QI) methods can accelerate testing of implementation strategies.
  • Previous efforts showed limited telemedicine uptake in pediatric transfers.

Purpose of the Study:

  • To test telemedicine implementation strategies for pediatric emergency consultations using QI methods.
  • To achieve high rates of telemedicine utilization for pediatric transfer consultations.
  • To identify key drivers for increasing telemedicine adoption.

Main Methods:

  • A multidisciplinary, multisite team utilized plan-do-study-act (PDSA) cycles.
  • Interventions included training, data dissemination, reminders, and workflow preparation.
  • Outcome measure: percentage of telemedicine consultations; balancing measure: time to consultation completion.

Main Results:

  • QI methods demonstrated special cause variation, leading to an increase in mean telemedicine use from 5% to 22%.
  • Key drivers identified: resource awareness, streamlined workflow, provider buy-in, and data transparency.
  • Consultation completion time remained unchanged, indicating no negative impact on efficiency.

Conclusions:

  • Quality improvement methods are effective for testing and implementing telemedicine strategies in pediatric emergency settings.
  • Targeted interventions can overcome barriers to telemedicine adoption.
  • QI provides a framework for rapid iteration and optimization of telemedicine services.