Research Coordinator, The Barbara Bush Children's Hospital Scholarship Academy at Maine Medical Center, Portland, Maine.
Faculty Scientist, MaineHealth Institute for Research, Portland, Maine.
Pediatr Neurol. 2024 Nov;160:1-7. doi: 10.1016/j.pediatrneurol.2024.07.013. Epub 2024 Jul 30.
Serial neonatal encephalopathy (NE) examinations are difficult to perform in rural community hospitals as on-site experts are not readily available. We implemented a synchronous, acute care model of teleconsultation-the Maine Neonatal Encephalopathy Teleconsultation program (Maine NET)-to provide remote, joint assessment of NE by pediatric neurology and neonatology at nine community hospitals and one tertiary care center. We performed a qualitative study to interview clinicians about their experience of this program.
From April 2018 to October 2022, we employed a semistructured interview format with 16 clinicians representing all participating hospitals. We utilized deductive analysis to assign a set of predefined codes to the transcribed interviews.
Thematic analysis supported the anticipated benefits of Maine NET, demonstrating that clinicians felt resource utilization, collaborative decision making, communication, and continuity of care were improved. Clinicians overwhelmingly supported the program: "This program has truly saved babies' lives and future function. I have not met any parents through this journey, who aren't incredibly grateful for the care that is provided" and emphasized the benefit of collaboration between all care team members. Teleconsultation was felt to be "more than adequate to [assess] NE." Connectivity issues were cited as a limitation.
Maine NET has positively impacted care delivery for newborns with clinical concerns for NE. Additionally, the program has improved resource allocation, collaborative decision making, communication, and equity of care. Addressing technological challenges will be vital to the success and sustainability of the planned Maine NET expansion.
在农村社区医院，由于现场专家不易获得，对新生儿脑病（NE）进行连续检查较为困难。我们实施了一种同步的急性护理模式的远程咨询 - 缅因州新生儿脑病远程咨询计划（Maine NET） - 以提供远程儿科神经病学和新生儿学对 9 家社区医院和 1 家三级护理中心的 NE 进行联合评估。我们进行了一项定性研究，对临床医生进行了有关该计划的经验访谈。
从 2018 年 4 月至 2022 年 10 月，我们对 16 名代表所有参与医院的临床医生采用了半结构化访谈格式。我们利用演绎分析将一组预定义的代码分配给转录访谈。
主题分析支持 Maine NET 的预期效益，表明临床医生认为资源利用、协作决策、沟通和护理连续性得到了改善。临床医生普遍支持该计划：“该计划真正挽救了婴儿的生命和未来的功能。通过这个项目，我还没有遇到任何父母不感谢所提供的护理”，并强调了所有护理团队成员之间合作的好处。远程咨询被认为“足以[评估] NE”。连接问题被认为是一个限制。
缅因州新生儿脑病远程咨询计划对有 NE 临床症状的新生儿的护理提供产生了积极影响。此外，该计划改善了资源分配、协作决策、沟通和护理公平性。解决技术挑战对于计划中的缅因州新生儿脑病远程咨询计划的成功和可持续性至关重要。
