A mixed-methods exploration of the Real-Time Virtual Support pathway Child Health Advice in Real-Time Electronically in Northwestern BC.

IF 1.8 4区医学 Q2 PEDIATRICS Paediatrics & child health Pub Date : 2024-10-10 eCollection Date: 2024-09-01 DOI:10.1093/pch/pxae063

Sean Duke, Jenna Treissman, Shannon Freeman, Emma Rossnagel, Salima Somani, Alam Lakhani, Kirsten Miller, John Pawlovich, David Wensley

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Abstract

Objectives: To explore the implementation of a provincial virtual paediatric consulting service, Child Health Advice in Real-Time Electronically (CHARLiE), integrated into the paediatric on-call schedule in Northwestern British Columbia.

Methods: Healthcare providers in Northwestern British Columbia responded to a survey (n = 72) and participated in focus groups (n = 35) and key informant interviews (n = 4) to share their experiences engaging in a healthcare model that incorporated virtual paediatric consultants in lieu of in-person local paediatrician coverage over a 28-month period. Survey data was analyzed using descriptive statistics. Themes were generated from a qualitative descriptive approach to focus groups and key informant interview transcripts.

Results: 96.1% of survey respondents who had used CHARLiE rated it as 'good' or 'very good' in the provision of overall support, while 77.6% reported that CHARLiE improved access to paediatric care. Focus group and key informant interview participants valued CHARLiE's timely, dedicated virtual bedside assessments of patients; collegiality and professionalism; amelioration of local paediatrician burnout; prevention of unnecessary transfers; and offloading of indirect patient care tasks. Video support improved provider confidence and appeared to improve caregiver trust. Suggested improvements included addressing technological barriers, enhancing providers' knowledge of local resources, and enabling continuity of care. Participants identified that virtual care does not replace on-the-ground specialist care.

Conclusions: Participants valued CHARLiE's 24/7, timely, and collegial video support. While maintaining a full complement of on-the-ground paediatricians remains the goal for some rural communities, dedicated virtual support provides access to paediatric care in smaller communities, thereby improving health equity for children in British Columbia.

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不列颠哥伦比亚省西北部电子实时儿童健康咨询实时虚拟支持途径的混合方法探索。

目的方法：不列颠哥伦比亚省西北部的医疗服务提供者参与了一项调查（72 人），并参加了焦点小组（35 人）和关键信息提供者访谈（4 人），以分享他们在 28 个月内参与医疗保健模式的经验，该模式纳入了虚拟儿科顾问，以取代当地儿科医生的亲自值班。调查数据采用描述性统计方法进行分析。通过对焦点小组和关键信息提供者访谈记录的定性描述方法得出主题：在使用过 CHARLiE 的调查对象中，96.1% 的人认为 CHARLiE 提供的整体支持 "好 "或 "非常好"，77.6% 的人认为 CHARLiE 改善了儿科医疗服务。焦点小组和关键信息提供者访谈的参与者对 CHARLiE 的以下方面给予了高度评价：对病人进行及时、专门的虚拟床旁评估；同事间的合作和专业精神；改善当地儿科医生的职业倦怠；防止不必要的转院；以及减轻间接的病人护理任务。视频支持增强了提供者的信心，似乎也提高了护理人员的信任度。建议的改进措施包括解决技术障碍、增强提供者对当地资源的了解以及实现护理的连续性。与会者认为，虚拟护理并不能取代现场专家护理：与会者对 CHARLiE 的全天候、及时和同事间的视频支持给予了高度评价。对于一些农村社区来说，保持完整的儿科医生队伍仍然是目标，但专门的虚拟支持为较小的社区提供了儿科医疗服务，从而提高了不列颠哥伦比亚省儿童的健康公平性。

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来源期刊

Paediatrics & child health 医学-小儿科

CiteScore

2.10

自引率

5.30%

发文量

208

审稿时长

>12 weeks

期刊介绍： Paediatrics & Child Health (PCH) is the official journal of the Canadian Paediatric Society, and the only peer-reviewed paediatric journal in Canada. Its mission is to advocate for the health and well-being of all Canadian children and youth and to educate child and youth health professionals across the country. PCH reaches 8,000 paediatricians, family physicians and other child and youth health professionals, as well as ministers and officials in various levels of government who are involved with child and youth health policy in Canada.