Emory University, Atlanta, GA, USA.
Harvard University, Cambridge, MA, USA.
Med Care Res Rev. 2023 Feb;80(1):79-91. doi: 10.1177/10775587221108750. Epub 2022 Jul 11.
The COVID-19 pandemic pushed hospitals to deliver care outside of their four walls. To successfully scale virtual care delivery, it is important to understand how its implementation affects frontline workers, including their teamwork and patient-provider interactions. We conducted in-depth interviews of 17 clinicians and staff involved with the COVID-19 Virtual Observation Unit (CVOU) in the emergency department (ED) of an academic hospital. The program leveraged remote patient monitoring and mobile integrated health care. In the CVOU (vs. the ED), participants observed increases in interactions among clinicians and staff, patient participation in care delivery, attention to nonmedical factors, and involvement of coordinators and paramedics in patient care. These changes were associated with unintended, positive consequences for staff, namely, feeling heard, experience of meaningfulness, and positive attitudes toward virtual care. This study advances research on reconfiguration of roles following implementation of new practices using digital tools, virtual work interactions, and at-home care delivery.
新冠疫情大流行促使医院将医疗服务拓展到医院围墙之外。为了成功扩大虚拟医疗服务规模，了解其实施如何影响一线工作人员（包括他们的团队合作和医患互动）非常重要。我们对参与学术医院急诊科新冠虚拟观察单元（CVOU）的 17 名临床医生和工作人员进行了深入访谈。该项目利用远程患者监测和移动综合医疗。在 CVOU（与 ED 相比），参与者观察到临床医生和工作人员之间的互动、患者参与护理、对非医疗因素的关注以及协调员和护理人员参与患者护理的增加。这些变化对员工产生了意想不到的积极影响，即感到被倾听、体验到意义感以及对虚拟护理的积极态度。这项研究推进了关于在使用数字工具、虚拟工作互动和家庭护理后实施新实践对角色重新配置的研究。
