Increasing Use of Ambulatory Video Visits for Pediatric Patients by Using Quality Improvement Methods

Rosenthal, Jennifer L.; Sigal, Ilana; Kamerman-Kretzmer, Rory; Say, Daphne S.; Castellanos, B. Cancho; Nguyen, Stéphanie; Nakra, Natasha; Restrepo, Bibiana; Crossen, Stephanie S.

doi:10.1097/pq9.0000000000000424

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…However, as seen in related studies, the pandemic created the momentum necessary to implement telemedicine rapidly and to demonstrate the benefits of this healthcare delivery approach. 29 The challenges noted in this QI project and the changes and ideas developed and tested by the team mirror those noted in other telemedicine QI projects with pediatric patients conducted before and during the pandemic. Key challenges highlighted by other projects also included low staff buy-in, siloed work, insufficient allocated work hours for the Pediatric Quality and Safety front-end staff, low health system capacity to support the implementation of video telemedicine, and limited health system experience with billing for video telemedicine.…”

Section: Discussionmentioning

confidence: 57%

Telemedicine Quality Improvement during the Corona Virus 2019 Pandemic Increases Pediatric Weight Management Access

Vallabhan,

Foos,

Roldan

et al. 2024

Pediatric Quality &Amp; Safety

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Background: The corona virus 2019 pandemic disrupted care for pediatric patients with chronic conditions, including those with childhood obesity. Lockdowns forced providers to create new ways of caring for this population. Telemedicine was a promising but previously unavailable solution. This quality improvement report details how the Healthy and Fit Children’s Clinic transitioned and improved care via telemedicine. Methods: Between March 2020 and April 2021, the quality improvement project team incorporated the Model for Improvement to transition the clinic to telemedicine. The team tracked Healthy and Fit Children’s Clinic appointments, no-shows, billing and reimbursement data, and noted unintended consequences or unanticipated barriers. Patients and their families were given a satisfaction survey at the end of each telemedicine encounter. Results: Compared with pre-telemedicine implementation, there was a 120% increase in completed patient clinic visits per week and a sustained positive shift above the established baseline. Telemedicine no-show rates achieved <10%, with an average sustained rate of <20%, compared with unchanged in-person no-show rates of >50% pre- and post-telemedicine implementation. There was a 74% increase in monthly billing and a sustained positive shift above the pre-telemedicine baseline. On average, patients rated all six satisfaction questions ≥92 on the 100-point scale (compared with 83 pre-telemedicine). Conclusions: This transition to telemedicine was successful and could be translatable to other clinic sites. Patients attended their clinic visits more consistently and were highly satisfied with their care. In a population where continuity of care is paramount, telemedicine shows promise as a tool to treat childhood obesity.

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Section: Discussionmentioning

confidence: 57%

Telemedicine Quality Improvement during the Corona Virus 2019 Pandemic Increases Pediatric Weight Management Access

Vallabhan,

Foos,

Roldan

et al. 2024

Pediatric Quality &Amp; Safety

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“… 17–19 In addition, efforts to encourage providers to use telehealth have been described in prior publications. 20 , 21 …”

Section: Discussionmentioning

confidence: 99%

Enhancing the Implementation of the Virtual Pediatric Trauma Center Using Practical, Robust, Implementation and Sustainability Model: A Mixed-Methods Study

Rosenthal

Haynes

Bonilla

et al. 2022

Telemedicine Reports

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Background: This article describes factors related to adoption, implementation, and effectiveness of the Virtual Pediatric Trauma Center intervention, which uses telehealth for trauma specialist consultations for seriously injured children. We aimed at (1) measuring RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) implementation outcomes and (2) identifying PRISM (Practical, Robust, Implementation, and Sustainability Model) contextual factors that influenced the implementation outcomes. Methods: This interim implementation evaluation of our telehealth trial used a convergent mixed-methods design. The quantitative component was a cross-sectional analysis of pediatric trauma encounters using electronic health records. The qualitative component was a thematic analysis of written and verbal feedback from providers and family advisory board meetings. We compared the quantitative and qualitative data by synthesizing them in a joint display table, organized by RE-AIM dimensions. We categorized these key findings into the PRISM domains. Results: During the first 10 months of this trial, 246 subjects were randomized, with 177 assigned to standard care and 69 assigned to telehealth. Four referring sites transitioned from standard care into their intervention period. PRISM contextual factors that influenced RE-AIM implementation outcomes included the following findings: Providers struggle to remember, interpret, and navigate intervention workflows; providers have preconceived ideas about the intervention purpose; the intervention mitigates parents' anxieties about the transfer process. Discussion: This study revealed implementation challenges that influence the overall success of this telehealth trial. Early identification of these challenges allows our team the opportunity to address them now to optimize the intervention reach, adoption, and implementation. This early action will ultimately enhance the success of our trial and the ability of our intervention to achieve broad impact.

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Increasing Use of Ambulatory Video Visits for Pediatric Patients by Using Quality Improvement Methods

Cited by 2 publications

References 20 publications

Telemedicine Quality Improvement during the Corona Virus 2019 Pandemic Increases Pediatric Weight Management Access

Telemedicine Quality Improvement during the Corona Virus 2019 Pandemic Increases Pediatric Weight Management Access

Enhancing the Implementation of the Virtual Pediatric Trauma Center Using Practical, Robust, Implementation and Sustainability Model: A Mixed-Methods Study

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