Enhancing the Implementation of the Virtual Pediatric Trauma Center Using Practical, Robust, Implementation and...

Area of Science:

• Pediatric Trauma Care
• Telehealth Interventions
• Implementation Science

Background:

• The Virtual Pediatric Trauma Center (VPTeC) intervention utilizes telehealth for expert consultations for critically injured children.
• This study evaluates factors influencing the adoption, implementation, and effectiveness of the VPTeC.

Purpose of the Study:

• To measure Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) outcomes of the VPTeC intervention.
• To identify Practical, Robust, Implementation, and Sustainability Model (PRISM) contextual factors impacting implementation.

Main Methods:

• A convergent mixed-methods design was employed for an interim implementation evaluation.
• Quantitative data from electronic health records and qualitative data from provider feedback and family advisory boards were analyzed.
• Data were synthesized using a joint display table organized by RE-AIM dimensions and categorized by PRISM domains.

Main Results:

• During the first 10 months, 246 subjects were randomized (69 to telehealth, 177 to standard care).
• Four sites transitioned to the intervention period.
• Key PRISM factors influencing RE-AIM outcomes included provider difficulties with intervention workflows, preconceived notions about the intervention, and its success in reducing parental anxiety.

Conclusions:

• Implementation challenges were identified that could affect the overall success of the telehealth trial.
• Early identification and addressing of these challenges are essential for optimizing intervention reach, adoption, and implementation.
• Proactive management of these factors will enhance trial success and the intervention's potential for broad impact.