Closing Pediatric Asthma Care Gaps Through School-Based Telehealth: A Quality Improvement Initiative.

IF 2.5 4区 医学 Q2 HEALTH POLICY & SERVICES Journal of Pediatric Health Care Pub Date : 2024-12-14 DOI:10.1016/j.pedhc.2024.11.003
Amanda K Vickers, Robert Darzynkiewicz, Kelli Garber, Michael Maymi
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Abstract

Background: Uncontrolled pediatric asthma leads to poorer outcomes; school-based telehealth (SBTH) is an opportunity to intervene.

Local problem: The connection rate to primary care after SBTH visits for asthma exacerbations was below organizational goals. Additionally, there was a gap in assessing SBTH's role in providing access to rescue medication.

Method: A 3-month plan-do-study-act design was used to improve SBTH referral rates among SBTH providers. Data was collected via EHR reports and chart reviews.

Interventions: SBTH providers were trained to complete a 3-question checklist on referral orders for all patients treated for an asthma exacerbation.

Results: Chi-square analysis showed a statistically significant increase (p < .001) in the "Connect to PCP" rate, 21% to 71%. Additionally, 86% of eligible participants had access to rescue medication at school, with one-third requiring SBTH to bridge a gap.

Conclusions: PCP connection can be increased; however, automation is needed for sustainability. Additionally, SBTH may increase access to asthma medication.

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通过校本远程保健缩小小儿哮喘护理差距:质量改进计划。
背景:未经控制的儿童哮喘导致较差的预后;基于学校的远程医疗(SBTH)是一个进行干预的机会。局部问题:哮喘加重SBTH就诊后的初级保健接通率低于组织目标。此外,在评估SBTH在提供救援药物方面的作用方面存在差距。方法:采用为期3个月的计划-研究-行动设计来提高SBTH提供者的转诊率。通过电子病历报告和图表审查收集数据。干预措施:对SBTH提供者进行了培训,以完成所有接受哮喘加重治疗的患者转诊命令的3个问题清单。结果:卡方分析显示,“连接到PCP”的比率增加了21%至71%,具有统计学意义(p < 0.001)。此外,86%的合格参与者在学校获得了救援药物,三分之一的人需要SBTH来弥补差距。结论:PCP连接可增加;然而,可持续发展需要自动化。此外,SBTH可能会增加获得哮喘药物的机会。
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来源期刊
CiteScore
3.40
自引率
10.70%
发文量
140
审稿时长
24 days
期刊介绍: The Journal of Pediatric Health Care, the official journal of the National Association of Pediatric Nurse Practitioners, provides scholarly clinical information and research regarding primary, acute and specialty health care for children of newborn age through young adulthood within a family-centered context. The Journal disseminates multidisciplinary perspectives on evidence-based practice and emerging policy, advocacy and educational issues that are of importance to all healthcare professionals caring for children and their families.
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