1 Department of Pediatric and Adolescent Medicine, Division of Neonatal Medicine , Mayo Clinic, Rochester, Minnesota.
2 Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic, Rochester, Minnesota.
Telemed J E Health. 2018 Oct;24(10):811-817. doi: 10.1089/tmj.2017.0182. Epub 2018 Feb 8.
Teleneonatology may improve the quality of high-risk newborn resuscitations performed by general providers in community settings. Variables that affect teleneonatology utilization have not been identified.
The objective of our mixed-methods study was to understand the barriers and facilitators experienced by local care providers who receive teleneonatology services.
In October 2015, an electronic survey was sent to 349 teleneonatology participants at 6 community hospitals to assess user satisfaction, technology usability and acceptability, and impact on patient care. From December 2015 to June 2016, 49 participants were involved in focus groups and individual interviews to better understand barriers and facilitators of teleneonatology implementation. Qualitative data were analyzed using a thematic approach.
Survey response rate was 31.8% (N = 111). Of 93 survey respondents, 88 (94.6%) agreed that teleneonatology was needed at their hospitals, and of 52 participants, 50 (96.2%) believed that teleneonatology consults were helpful. We identified multiple facilitators and barriers to program implementation in education and training, process and work flow, communication, and technology.
Local care teams believed that teleneonatology was valuable for connection to a remote neonatologist. Successful program implementation may be facilitated by communicating the value of teleneonatology, engaging local stakeholders in program training and education, maintaining supportive professional relationships, and designing simple, highly reliable clinical work flows.
Teleneonatology is viewed as an innovative, valuable service by local care teams. The identified barriers and facilitators to program use should be considered when implementing a teleneonatology program.
远程新生儿学可以提高社区环境中普通医务人员对高危新生儿复苏的质量。影响远程新生儿学利用的变量尚未确定。
我们的混合方法研究的目的是了解接受远程新生儿学服务的当地护理人员所经历的障碍和促进因素。
2015 年 10 月，向 6 家社区医院的 349 名远程新生儿学参与者发送了电子调查，以评估用户满意度、技术可用性和可接受性，以及对患者护理的影响。2015 年 12 月至 2016 年 6 月，49 名参与者参与了焦点小组和个人访谈，以更好地了解远程新生儿学实施的障碍和促进因素。使用主题方法对定性数据进行分析。
调查回复率为 31.8%（N=111）。在 93 名调查应答者中，88 名（94.6%）同意他们医院需要远程新生儿学，在 52 名参与者中，有 50 名（96.2%）认为远程新生儿学咨询有帮助。我们确定了教育和培训、流程和工作流程、沟通和技术方面实施计划的多个促进因素和障碍。
当地护理团队认为远程新生儿学对于与远程新生儿科医生建立联系很有价值。通过传达远程新生儿学的价值、让当地利益相关者参与项目培训和教育、保持支持性的专业关系以及设计简单、高度可靠的临床工作流程，可以促进计划的顺利实施。
远程新生儿学被当地护理团队视为一种创新且有价值的服务。在实施远程新生儿学计划时，应考虑到计划使用的障碍和促进因素。
