ABSTRACT
PURPOSE: To describe our methodology for implementing synchronous telemedicine during the 2019 novel coronavirus (COVID-19) pandemic. METHODS: A retrospective review of outpatient records at a single children's hospital from March 21 to April 10, 2020, was carried out to determine the outcome of already-scheduled face-to-face outpatient appointments. The week leading up to the March 21, all appointments in the study period were categorized as follows: (1) requiring an in-person visit, (2) face-to-face visit that could be postponed, and (3) consultation required but could be virtual. Teams of administrators, schedulers, and ophthalmic technicians used defined scripts and standardized emails to communicate results of categorization to patients. Flowcharts were devised to schedule and implement telemedicine visits. Informational videos were made accessible on social media to prepare patients for the telemedicine experience. Simultaneously our children's hospital launched a pediatric on-demand e-consult service, the data analytics of which could be used to determine how many visits were eye related. RESULTS: A total of 237 virtual ophthalmology consult visits were offered during the study period: 212 were scheduled, and 206 were completed, of which 43 were with new patients and 163 with returning patients. Following the initial virtual visit, another was required on average in 4 weeks by 21 patients; in-person follow-up was required for 170 patients on average 4.6 months after the initial virtual visit. None needed review within 72 hours. The pediatric on-demand service completed 290 visits, of which 25 had eye complaints. CONCLUSIONS: With proper materials, technology, and staffing, a telemedicine strategy based on three patient categories can be rapidly implemented to provide continued patient care during pandemic conditions. In our study cohort, the scheduled clinic e-visits had a low no-show rate (3%), and 8% of the on-demand virtual access for pediatric care was eye related.
Subject(s)
COVID-19/epidemiology , Eye Diseases/diagnosis , Ophthalmology/methods , Pandemics , Patient Satisfaction , Referral and Consultation/organization & administration , Telemedicine/methods , Child , Comorbidity , Eye Diseases/epidemiology , Female , Humans , Male , Retrospective Studies , United States/epidemiologyABSTRACT
In a pay-for-performance home health system, achieving superior patient outcomes becomes the key to agency success. Evidence-based guidelines help in the achievement of exceptional patient outcomes. In this article, the Wisconsin Homecare Organization (WHO) describes its journey toward basing its home health practice on evidence-based guidelines.
Subject(s)
Community Health Nursing/standards , Evidence-Based Medicine/standards , Home Care Services/standards , Nursing Research/standards , Practice Guidelines as Topic , Benchmarking , Clinical Competence , Community Health Nursing/education , Documentation/standards , Evidence-Based Medicine/education , Humans , Manuals as Topic , Needs Assessment/standards , Nurse's Role , Nursing Assessment/standards , Nursing Audit , Nursing Research/education , Outcome Assessment, Health Care , Patient Care Planning/standards , Patient Education as Topic/standards , Total Quality Management , WisconsinABSTRACT
As the focus on accountability in health care increases, there has been a corresponding emphasis on establishing core competencies for health care workers. This article discusses the development of an instrument to establish core competencies for workers in inpatient mental health settings. Twenty-six competencies were identified and rated by mental health care personnel on two subscales: the importance of the competency and how much behavioral health care workers could benefit from training on the competency. The reliability of the scale and its contributions to the training, retention and recruitment of direct care workers for behavioral health are discussed.