Nurse-Led Visits Reduce In-Person Referral From Urgent Care Telehealth

Area of Science:

• Pediatric Urgent Care
• Telehealth Innovations
• Quality Improvement in Healthcare

Background:

• Pediatric urgent care telehealth services often result in in-person referrals for further evaluation.
• There is a need for efficient and effective interventions within the telehealth setting to reduce unnecessary in-person visits.

Purpose of the Study:

• To evaluate the impact of implementing nurse-led visits on in-person referrals from pediatric urgent care telehealth.
• To assess the safety and effectiveness of nurse-led diagnostic and therapeutic interventions in a virtual care setting.

Main Methods:

• A quality improvement study was conducted in pediatric urgent care clinics and telehealth services.
• Nurse-led visits were implemented to provide interventions like rapid strep testing and urinalysis without requiring a separate clinical evaluation.
• The primary outcome measured was the percentage of telehealth encounters with in-person referrals, tracked using control charts.

Main Results:

• In-person referrals decreased from 23.0% to 12.3% post-implementation of nurse-led visits.
• Nurse-led visits were associated with shorter lengths of stay (32 min vs. 69 min) and cost savings of $135.
• Only 2.8% of nurse-led visits resulted in return visits within 72 hours.

Conclusions:

• Integrating nurse-led visits into telehealth is a safe and effective strategy for delivering diagnostic and therapeutic interventions.
• This model expands access to high-quality acute care, reduces unnecessary referrals, and supports evidence-based practice in pediatric urgent care.