Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Pediatric Endocrinology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Pediatr Diabetes. 2021 May;22(3):463-468. doi: 10.1111/pedi.13180. Epub 2021 Feb 16.
Pediatric diabetes clinics around the world rapidly adapted care in response to COVID-19. We explored provider perceptions of care delivery adaptations and challenges for providers and patients across nine international pediatric diabetes clinics.
Providers in a quality improvement collaborative completed a questionnaire about clinic adaptations, including roles, care delivery methods, and provider and patient concerns and challenges. We employed a rapid analysis to identify main themes.
Providers described adaptations within multiple domains of care delivery, including provider roles and workload, clinical encounter and team meeting format, care delivery platforms, self-management technology education, and patient-provider data sharing. Providers reported concerns about potential negative impacts on patients from COVID-19 and the clinical adaptations it required, including fears related to telemedicine efficacy, blood glucose and insulin pump/pen data sharing, and delayed care-seeking. Particular concern was expressed about already vulnerable patients. Simultaneously, providers reported 'silver linings' of adaptations that they perceived as having potential to inform care and self-management recommendations going forward, including time-saving clinic processes, telemedicine, lifestyle changes compelled by COVID-19, and improvements to family and clinic staff literacy around data sharing.
Providers across diverse clinical settings reported care delivery adaptations in response to COVID-19-particularly telemedicine processes-created challenges and opportunities to improve care quality and patient health. To develop quality care during COVID-19, providers emphasized the importance of generating evidence about which in-person or telemedicine processes were most beneficial for specific care scenarios, and incorporating the unique care needs of the most vulnerable patients.
世界各地的儿科糖尿病诊所迅速调整了医疗服务，以应对 COVID-19。我们探讨了 9 家国际儿科糖尿病诊所的医护人员对医疗服务调整的看法，以及这些调整对医护人员和患者带来的挑战。
参与质量改进合作的医护人员完成了一份有关诊所调整的问卷，包括角色、护理方式、医护人员和患者的担忧及挑战。我们采用快速分析方法来确定主要主题。
医护人员描述了多个护理领域的调整，包括医护人员的角色和工作量、临床诊疗和团队会议的形式、护理提供平台、自我管理技术教育以及患者与医护人员的数据共享。医护人员表示担忧 COVID-19 及其所需的临床调整可能会对患者产生负面影响，包括对远程医疗疗效、血糖和胰岛素泵/笔数据共享以及延迟寻求护理的担忧。他们尤其关注那些已经脆弱的患者。同时，医护人员报告了他们认为可能会为未来的护理和自我管理建议提供信息的“一线希望”，包括节省时间的诊所流程、远程医疗、COVID-19 引发的生活方式改变，以及提高了数据共享方面的家庭和诊所工作人员的读写能力。
来自不同临床环境的医护人员报告了应对 COVID-19 的护理服务调整，特别是远程医疗流程——这既带来了挑战，也为改善护理质量和患者健康提供了机会。为了在 COVID-19 期间提供优质的护理，医护人员强调了制定有关特定护理场景中哪种面对面或远程医疗流程最有益的证据的重要性，并将最脆弱患者的独特护理需求纳入考虑。
