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Telemedicine Medical Screening Evaluation Expedites the Initiation of Emergency Care for Children.
Friedman, Jonathan; Lame, Maria; Clark, Sunday; Gogia, Kriti; Platt, Shari L; Kim, Ji Won.
Afiliação
  • Friedman J; From the Division of Pediatric Emergency Medicine, Department of Pediatrics, New York City Health and Hospitals, Jacobi Medical Center; Division of Pediatric Emergency Medicine, Departments of.
  • Clark S; Department of Emergency Medicine, NewYork-Presbyterian, Weill Cornell Medicine, New York, NY.
  • Gogia K; Department of Emergency Medicine, NewYork-Presbyterian, Weill Cornell Medicine, New York, NY.
Pediatr Emerg Care ; 37(7): e417-e420, 2021 Jul 01.
Article em En | MEDLINE | ID: mdl-33848095
ABSTRACT

OBJECTIVE:

Prior studies show that staffing a physician at triage expedites care in the emergency department. Our objective was to describe the novel application and effect of a telemedicine medical screening evaluation (Tele-MSE) at triage on quality metrics in the pediatric emergency department (PED).

METHODS:

We conducted a retrospective quasi-experimental pre-post intervention study of patients presenting to an urban PED from December 2017 to November 2019 who received a Tele-MSE at triage. We analyzed 4 diagnostic cohorts gastroenteritis, psychiatry evaluation, burn injury, and extremity fracture. We matched cases with controls who received standard triage, from December 2015 to November 2017, by age, diagnosis, weekday versus weekend, and season of presentation. Outcome measures included door-to-provider time, time-to-intervention order, and PED length of stay (LOS).

RESULTS:

We included 557 patients who received Tele-MSE during the study period. Compared with controls, patients who received a Tele-MSE at triage had a shorter median door-to-provider time (median difference [MD], 8.4 minutes; 95% confidence interval [CI], 6.0-11.0), time-to-medication order (MD, 27.3 minutes; 95% CI, 22.9-35.2), time-to-consult order (MD, 10.0 minutes; 95% CI, 5.3-12.7), and PED LOS (MD, 0.4 hours; 95% CI, 0.3-0.6).

CONCLUSIONS:

A Tele-MSE is an innovative modality to expedite the initiation of emergency care and reduce PED LOS for children. This novel intervention offers potential opportunities to optimize provider and patient satisfaction and safety during the COVID-19 pandemic.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Triagem / Telemedicina / Serviço Hospitalar de Emergência Tipo de estudo: Diagnostic_studies / Observational_studies / Screening_studies Limite: Child / Humans Idioma: En Revista: Pediatr Emerg Care Assunto da revista: MEDICINA DE EMERGENCIA / PEDIATRIA Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Triagem / Telemedicina / Serviço Hospitalar de Emergência Tipo de estudo: Diagnostic_studies / Observational_studies / Screening_studies Limite: Child / Humans Idioma: En Revista: Pediatr Emerg Care Assunto da revista: MEDICINA DE EMERGENCIA / PEDIATRIA Ano de publicação: 2021 Tipo de documento: Article