Preserving Multidisciplinary Care Model and Patient Safety During Reopening of Ambulatory Cystic Fibrosis Clinic for Nonurgent Care: A Hybrid Telehealth Model
Preserving Multidisciplinary Care Model and Patient Safety During Reopening of Ambulatory Cystic Fibrosis Clinic for Nonurgent Care: A Hybrid Telehealth Model
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DOI：
10.1089/tmj.2020.0247
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发表时间：
2021-02-01
影响因子：
4.7
通讯作者：
Albon, Dana
中科院分区：
文献类型：
--
作者：
List, Rhonda;Compton, Martina;Albon, Dana
简介：弗吉尼亚大学（UVA）成人囊性纤维化（CF）项目于2020年3月中旬实施了快速成功的远程医疗护理过渡，以应对2019年冠状病毒病（COVID-19）大流行。2020年5月，UVA CF成人项目重新设计了护理模式，以适应门诊业务的重新开放，并引入了混合诊所。目标仍然是尽量减少患者和护理团队成员（CTM）的人与人之间的接触，同时确保患者能够获得季度、共同制作、同步、多学科的CF护理，类似于COVID-19前的常规CF护理。方法：使用质量改进工具，UVA成人CF程序创建了一个标准化的混合模型的护理在诊所访问，其中包括在人和同步虚拟互动与多学科团队的成员相结合的组件。结果：2020年5月14日至6月11日期间共发生16次混合访视。所有混合访视均为多学科访视，满足了患者要求查看CTM的要求。通过混合接触观察的所有患者均参加了共同制定的议程设置，接受了肺量测定，并获得了血液检查; 75%的患者提供了痰液进行监测培养。每种混合访问类型平均有4名CTM参加，共计63次单独的互动。在这些互动中，有28个是虚拟完成的，与完全面对面的护理模式相比，面对面接触和个人防护设备的使用减少了44%。结论：在多学科CF护理模式中结合面对面和远程医疗组件，减少了患者和工作人员的互动和个人防护设备的使用。面对面/远程联合护理的混合模式可以可靠地访问生物数据，以支持医疗决策，同时降低患者和工作人员面对面接触的风险。简介：弗吉尼亚大学（UVA）成人囊性纤维化（CF）项目于2020年3月中旬实施了快速成功的远程医疗护理过渡，以应对2019冠状病毒病（COVID-19）大流行。2020年5月，UVA CF成人项目重新设计了护理模式，以适应门诊业务的重新开放，并引入了混合诊所。目标仍然是尽量减少患者和护理团队成员（CTM）的人与人之间的接触，同时确保患者能够获得季度、共同制作、同步、多学科的CF护理，类似于COVID-19前的常规CF护理。方法：使用质量改进工具，UVA成人CF程序创建了一个标准化的混合模型的护理在诊所访问，其中包括在人和同步虚拟互动与多学科团队的成员相结合的组件。结果：2020年5月14日至6月11日期间共发生16次混合访视。所有混合访视均为多学科访视，满足了患者要求查看CTM的要求。通过混合接触观察的所有患者均参加了共同制定的议程设置，接受了肺量测定，并获得了血液检查; 75%的患者提供了痰液进行监测培养。每种混合访问类型平均有4名CTM参加，共计63次单独的互动。在这些互动中，有28个是虚拟完成的，与完全面对面的护理模式相比，面对面接触和个人防护设备的使用减少了44%。结论：在多学科CF护理模式中结合面对面和远程医疗组件，减少了患者和工作人员的互动和个人防护设备的使用。现场/远程综合护理的混合模式能够可靠地访问生物数据，以支持医疗决策，同时减轻患者和工作人员的人与人接触的风险。
Introduction:The University of Virginia's (UVA's) adult cystic fibrosis (CF) program implemented a rapid and successful transition to telemedicine care mid-March of 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. In May 2020, the adult UVA CF program redesigned the care model to adjust to the reopening of ambulatory operations and introduced hybrid clinics. The goal remained to minimize person-to-person contacts for patients and care team members (CTMs) while ensuring patient access to quarterly, coproduced, synchronous, multidisciplinary CF care, similar to pre-COVID-19 era regular CF care. Methods:Using quality improvement tools, the UVA adult CF program created a standardized hybrid model of care for in-clinic visits, which included combined components of in-person and synchronous virtual interactions with members of the multidisciplinary team. Results:A total of 16 hybrid visits occurred between May 14 and June 11, 2020. All hybrid visits were multidisciplinary and fulfilled patient requests to see CTMs. All patients seen by hybrid encounter participated in coproduced agenda setting, underwent spirometry, and obtained blood work; 75% provided sputum for surveillance culture. Each hybrid visit type was attended by an average of four CTMs and amounted to 63 separate interactions. Of these interactions, 28 were completed virtually, reducing in-person contacts and personal protection equipment utilization by 44% compared with a fully in-person model of care. Conclusions:Combining in-person and telehealth components in a multidisciplinary CF care model reduces patient and staff interactions and personal protective equipment utilization. The hybrid model of in-person/remote combined care enables reliable access to biological data to support medical decision making while mitigating the risks of person-to-person contact for patients and staff.Introduction:The University of Virginia's (UVA's) adult cystic fibrosis (CF) program implemented a rapid and successful transition to telemedicine care mid-March of 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. In May 2020, the adult UVA CF program redesigned the care model to adjust to the reopening of ambulatory operations and introduced hybrid clinics. The goal remained to minimize person-to-person contacts for patients and care team members (CTMs) while ensuring patient access to quarterly, coproduced, synchronous, multidisciplinary CF care, similar to pre-COVID-19 era regular CF care. Methods:Using quality improvement tools, the UVA adult CF program created a standardized hybrid model of care for in-clinic visits, which included combined components of in-person and synchronous virtual interactions with members of the multidisciplinary team. Results:A total of 16 hybrid visits occurred between May 14 and June 11, 2020. All hybrid visits were multidisciplinary and fulfilled patient requests to see CTMs. All patients seen by hybrid encounter participated in coproduced agenda setting, underwent spirometry, and obtained blood work; 75% provided sputum for surveillance culture. Each hybrid visit type was attended by an average of four CTMs and amounted to 63 separate interactions. Of these interactions, 28 were completed virtually, reducing in-person contacts and personal protection equipment utilization by 44% compared with a fully in-person model of care. Conclusions:Combining in-person and telehealth components in a multidisciplinary CF care model reduces patient and staff interactions and personal protective equipment utilization. The hybrid model of in-person/remote combined care enables reliable access to biological data to support medical decision making while mitigating the risks of person-to-person contact for patients and staff.