Enochs Catherine, Filbrun Amy G, Iwanicki Courtney, Moraniec Haley, Lehrmann Julie, Stiffler Jourdan, Dagher Sharyn, Tapley Chris, Phan Hanna, Raines Rebekah, Nasr Samya Z
Department of Pediatrics, Michigan Medicine, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA.
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.
Telemed Rep. 2021 Oct 12;2(1):224-232. doi: 10.1089/tmr.2021.0021. eCollection 2021.
People with cystic fibrosis (PCF) have unique physical and emotional needs, which are best met through interdisciplinary care (IDC). In the midst of the pandemic, our center aimed to begin a telehealth care model with an objective to increase successful care visits from baseline of 0-95% by June 26, 2020, including meeting cystic fibrosis (CF) care standards of IDC visits that are coproduced through agenda setting with PCF. Shifting IDC for pediatric CF patients to telehealth was part of a quality improvement initiative. Our team used asynchronous virtual visits (VVs), with the IDC team members' VVs done on different days than the physician's. Multiple plan-do-study-act cycles were completed to address evolving telehealth needs, including IDC team member flow logistics, communication with PCF, and surveying PCF for the patient perspective. Rates of IDC and agenda setting were measured from March 16, 2020 to June 26, 2020. IDC VVs were at 86% in March 2020 with fluctuations until mid-May when we reached 100% and achieved sustainability. Agenda setting was reached at 100% and maintained. With continued effort, an additional 46.3% of PCF registered for the patient portal, totaling 90.6% with access. Our survey revealed 100% of PCF were able to see IDC team members that they needed to, with 87% "extremely satisfied" and 13% "somewhat satisfied" with their telehealth experience. Successful telehealth in pediatric CF IDC can be achieved through continuous communication, optimal utilization of available technologies, and may help foster unique opportunities to help improve health outcomes.
患有囊性纤维化的人(PCF)有独特的身体和情感需求,通过跨学科护理(IDC)能最好地满足这些需求。在疫情期间,我们的中心旨在启动一种远程医疗模式,目标是到2020年6月26日将成功护理就诊率从基线的0 - 95%提高,包括达到通过与PCF共同制定议程而产生的囊性纤维化(CF)跨学科护理就诊标准。将儿科CF患者的跨学科护理转移到远程医疗是质量改进计划的一部分。我们的团队采用了异步虚拟就诊(VV),跨学科护理团队成员的虚拟就诊与医生的在不同日期进行。完成了多个计划 - 执行 - 研究 - 行动循环,以满足不断变化的远程医疗需求,包括跨学科护理团队成员的流程安排、与PCF的沟通以及从患者角度对PCF进行调查。在2020年3月16日至2020年6月26日期间测量了跨学科护理和议程设定的比率。2020年3月跨学科护理虚拟就诊率为86%,之后有波动,直到5月中旬达到100%并实现可持续性。议程设定达到了100%并得以维持。通过持续努力,另外46.3%的PCF注册了患者门户,总计90.6%的人可以访问。我们的调查显示,100%的PCF能够见到他们需要的跨学科护理团队成员,87%的人对他们的远程医疗体验“极其满意”,13%的人“有些满意”。儿科CF跨学科护理中的成功远程医疗可以通过持续沟通、对现有技术的优化利用来实现,并且可能有助于创造独特机会来改善健康结果。