Hallford Henry G, Szyld Edgardo, McCoy Michael, Makkar Abhishek
Department of Pediatrics, Section of Neonatal and Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Am J Perinatol. 2024 May;41(S 01):e711-e718. doi: 10.1055/a-1932-9921. Epub 2022 Aug 29.
In 2013, the Section of Neonatal and Perinatal Medicine at the University of Oklahoma's Children's Hospital began providing advanced care to a regional level II neonatal intensive care unit (NICU), using a hybrid telemedicine program. This project compares health care providers' and parents' assessments of health care quality using this program.
This is a prospective, anonymous, nonrandomized survey of health care providers and parents of neonates using our hybrid telemedicine services. Physicians, neonatal nurse practitioners (NNPs), nurses, and parents completed pencil-and-paper surveys based on their participatory roles. Institutional Review Board approval was obtained at OU Medical Center and Comanche County Memorial Hospital. Surveys consisted of 5-point Likert's scale questions. Descriptive statistics compared the level of agreement with each question across participant groups. A service quality (SQ) composite score was created by summing responses from six SQ questions. Between-group analysis was done on the SQ score using the Mann-Whitney -test.
Nine physicians, 10 NNPs, 12 nurses, and 40 parents completed the survey. Providers agreed (90%) that telemedicine can effectively deliver advanced neonatal care; the care patients receive is comparable to direct patient care (87%); telemedicine enhanced overall patient care quality (90%); providers can effectively interact with each other and families using telemedicine (90.3%), and overall telemedicine experience was good (90%). In total, 61% of providers reported telemedicine improves physician-patient interaction. Parents of newborns agreed that they were well informed about telemedicine use for their child's care (88%), were able to communicate routinely with neonatologists (85%), and were comfortable with their child's physical examinations (93%). Provider's versus family's (SQ) score was not significantly different.
All survey participants, including neonatologists, NNPs, nurses, and patient families, reported high levels of satisfaction with the hybrid telemedicine model developed and implemented at this institution which may be comparable to in-person direct patient care.
· Implementation of a hybrid telemedicine system provides an alternative to the transfer of newborns needing advanced care to tertiary care facilities.. · In this study, both health care providers and patient family members were satisfied with the quality of care using hybrid telemedicine.. · In this study, families of newborns could fully participate in their child's care using the hybrid telemedicine system..
2013年，俄克拉荷马大学儿童医院的新生儿与围产期医学科开始通过一个混合远程医疗项目，为地区二级新生儿重症监护病房（NICU）提供高级护理。本项目比较了医疗服务提供者和家长对使用该项目的医疗质量评估。
这是一项对使用我们混合远程医疗服务的新生儿医疗服务提供者和家长进行的前瞻性、匿名、非随机调查。医生、新生儿执业护士（NNP）、护士和家长根据他们的参与角色完成纸笔调查。俄克拉荷马大学医学中心和科曼奇县纪念医院获得了机构审查委员会的批准。调查由5点李克特量表问题组成。描述性统计比较了各参与组对每个问题的认同程度。通过对六个服务质量（SQ）问题的回答进行求和，得出服务质量综合得分。使用曼-惠特尼检验对服务质量得分进行组间分析。
9名医生、10名新生儿执业护士、12名护士和40名家长完成了调查。医疗服务提供者一致认为（90%）远程医疗能够有效地提供高级新生儿护理；患者接受的护理与直接患者护理相当（87%）；远程医疗提高了整体患者护理质量（90%）；医疗服务提供者能够使用远程医疗有效地相互交流并与家庭沟通（90.3%），并且总体远程医疗体验良好（90%）。总体而言，61%的医疗服务提供者报告称远程医疗改善了医患互动。新生儿家长一致认为他们充分了解远程医疗在孩子护理中的使用情况（88%），能够与新生儿科医生定期沟通（85%），并且对孩子的体格检查感到放心（93%）。医疗服务提供者与家庭的（SQ）得分没有显著差异。
所有调查参与者，包括新生儿科医生、新生儿执业护士、护士和患者家属，都对该机构开发和实施的混合远程医疗模式表示高度满意，这种模式可能与亲自直接患者护理相当。
· 实施混合远程医疗系统为将需要高级护理的新生儿转诊至三级护理机构提供了一种替代方案。· 在本研究中，医疗服务提供者和患者家庭成员都对使用混合远程医疗的护理质量感到满意。· 在本研究中，新生儿家庭可以使用混合远程医疗系统充分参与孩子的护理。
