The Effect Of A Newborn Telehealth Program On Transfers Avoided: A Multiple-Baseline Study

Albritton, Jordan; Maddox, Lory J.; Dalto, Joseph; Ridout, Erick; Minton, Stephen D.

doi:10.1377/hlthaff.2018.05133

Cited by 49 publications

(39 citation statements)

References 24 publications

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“…The same access difficulties are present within the IH system, with much of specialized uroradiographic testing occurring at the only freestanding tertiary care pediatric hospital in the Intermountain West. Telehealth attempts to improve access and streamline care for rural patients in the IH and other systems [ 29 , 30 ]. However, the most important question, and one that is the subject of ongoing work by our group, is whether the reduced imaging rate leads to worse long-term renal function.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Schaeffer

Cartwright

Lau

et al. 2020

Advances in Urology

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Purpose. The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system. Study Design and Data Source. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria: (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth. Data Collection. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables. Primary Outcome. Sum of radiologic studies within the first year of life or prior to pyeloplasty. Statistical Analysis. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade. Results. Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR: 1.57; 95% CI: 1.42–1.73) and severe (RR: 2.09; 95% CI: 1.88–2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders. Conclusions. In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.

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Section: Discussionmentioning

confidence: 99%

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Schaeffer

Cartwright

Lau

et al. 2020

Advances in Urology

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“…The review protocol builds on (Smith et al, 2011 [184]), and was undertaken by two reviewers (NE & TCOH). 95.…”

Section: Review Protocolmentioning

confidence: 99%

“…As care can be delivered through telemedicine in a wide variety of contexts and ways, it is challenging to make broad statements regarding the cost-effectiveness of telemedicine services in general. Out of the 19 systematic reviews and/or meta-analyses focussing on cost-effectiveness of telemedicine interventions included in the umbrella review, eight found that telemedicine was or could potentially be cost-effective ( [109]). Cost-effective telemedicine interventions included the management of rheumatoid arthritis, computerised cognitive behavioural therapy (cCBT), teleglaucoma, telemedicine interventions delivered through mobile devices to provide support, information and collect data, pacemaker telemonitoring, eHealth interventions in somatic diseases, and teledermatology for triage.…”

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confidence: 99%

Bringing health care to the patient

Hashiguchi

2020

OECD Health Working Papers

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systems/health-working-papers.htm OECD Working Papers should not be reported as representing the official views of the OECD or of its member countries. The opinions expressed and arguments employed are those of the author(s). Working Papers describe preliminary results or research in progress by the author(s) and are published to stimulate discussion on a broad range of issues on which the OECD works. Comments on Working Papers are welcomed, and may be sent to health.contact@oecd.org. This series is designed to make available to a wider readership selected health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language-English or French-with a summary in the other. This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law.

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“…For example, evidence-based team training interventions such as TeamSTEPPS TM or crew resource management training can be used to improve teamwork during transitions [8][9][10][11][12]. Similarly, communication during transitions can be significantly improved through standardization, training, and simulation [13][14][15] and telemedicine may be a particularly useful approach in improving communication, particularly at the time of birth [16]. In addition, change ideas from the literature on standardization and high reliability theory such as use of checklists, clinical practice guidelines, and pathways can be used to reduce variation in care seen during clinical transitions [17][18][19][20].…”

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confidence: 99%

Variability in the systems of care supporting critical neonatal intensive care unit transitions

et al. 2020

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Objective Assess practices supporting care transitions for infants and families in the neonatal intensive care unit (NICU) using a model of four key drivers: communication, teamwork, family integration, and standardization. Study design Single-day audit among NICUs in the Vermont Oxford Network Critical Transitions collaborative addressing policies and practices supporting the four key drivers during admission, discharge, shift-to-shift handoffs, within hospital transfers, and select changes in clinical status. Results Among 95 NICUs, the median hospital rate of audited policies in place addressing the four key drivers were 47% (inter-quartile range (IQR) 35-65%) for communication, 67% (IQR 33-83%) for teamwork, 50% (IQR 33-61%) for family integration, and 70% (IQR 56-85%) for standardization. Of the 2462 infants included, 1066 (43%) experienced ≥1 specified transition during the week prior to the audit. Conclusions We identified opportunities for improving NICU transitions in areas of communication, teamwork, family integration, and standardization.

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The Effect Of A Newborn Telehealth Program On Transfers Avoided: A Multiple-Baseline Study

Cited by 49 publications

References 24 publications

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Bringing health care to the patient

Variability in the systems of care supporting critical neonatal intensive care unit transitions

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