Telemedicine for Children in Rural Emergency Departments

农村急诊科儿童远程医疗

• 批准号: 6897832
• 负责人: James P Marcin
• 金额: $ 12.18万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-19 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6897832
• 关键词: clinical research; critical care; data collection methodology /evaluation; emergency health services; health care quality; health care service evaluation; health care service utilization; health services research tag; human subject; medical records; medically underserved population; patient safety /medical error; pediatrics; questionnaires; rural area; satisfaction; telemedicine

DESCRIPTION (provided by applicant): Rural hospitals are often under served with respect to pediatric specialty and emergency services. As a consequence, acutely ill and injured children presenting to rural hospitals may receive delayed or inappropriate care. The use of telemedicine to provide under served hospitals with pediatric emergency and critical care telemedicine consultations has not been described, and the effect that these consultations would have on the processes, frequency of errors, outcomes and costs of health care provided to children is unknown. The objective of this application is to determine the impact of telemedicine consultations on the quality and satisfaction of care that critically ill and injured children receive in rural emergency departments. Preliminary data suggests that telemedicine consultations to a rural hospital can aid in the management of critically ill children. The candidate hypothesizes that emergency pediatric telemedicine consultations to rural, under served emergency departments will reduce the frequency of medication errors; enhance the quality of care as measured by implicit review; and decrease unnecessary patient transports. Furthermore, it is hypothesized that these departments will be regarded as high in quality compared to control emergency departments without telemedicine consultations. Two rural, under served emergency departments will be studied that will utilize telemedicine consultations for acutely ill and injured children (Telemedicine ED). The acutely ill and injured children presenting to the two matched control emergency departments (Control ED) will act as control subjects. Historical control data will be collected from all four emergency departments so that a pretest-posttest design with concurrent matched controls can be used. UC Davis Children?s Hospital critical care physicians will provide consultations to the rural emergency departments. Review of the blinded medical records will be used to determine medication error rates, implicit quality assessments, and patient transfer rates in the telemedicine and control emergency departments. Satisfaction surveys completed by the parents/guardians will also be compared between patients cared for in telemedicine and control emergency departments to evaluate the effects of telemedicine on overall patient satisfaction.

描述（由申请人提供）：农村医院往往服务不足 儿科专业和急诊服务。因此，在这方面， 到农村医院就诊的重病和受伤儿童可能会收到 延迟或不适当的护理。利用远程医疗提供服务不足的 拥有儿科急诊和重症监护远程医疗的医院 磋商没有被描述，这些磋商的效果 会对过程、错误频率、结果和健康成本产生影响， 对儿童的照料不详。本申请的目的是 确定远程医疗咨询对质量的影响， 农村危重伤儿童护理满意度调查 急诊室。初步数据显示，远程医疗 到农村医院咨询可以帮助管理危重病人， 孩子候选人假设紧急儿科远程医疗 向服务不足的农村急诊部门提供咨询， 用药错误的频率;提高护理质量， 隐式审查;减少不必要的病人运输。而且 假设这些部门将被视为高质量 与没有远程医疗咨询的对照急诊室相比。 将研究两个服务不足的农村急诊部门， 为重病和受伤儿童提供远程医疗咨询 （远程医疗艾德）。两个受伤的重病儿童 匹配的对照急诊科（对照艾德）将作为对照 科目将从所有四个紧急事件中收集历史对照数据 因此，采用前后测设计，同时进行匹配控制 可以使用加州大学戴维斯分校儿童？医院重症监护医生将 为农村急救部门提供咨询。审查 将使用盲法医疗记录来确定用药错误率， 隐式质量评估和远程医疗中的患者转移率 控制急诊室完成的满意度调查 父母/监护人也将在接受护理的患者之间进行比较， 远程医疗和控制急诊科，以评估效果， 远程医疗对患者整体满意度的影响。