权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Telemedicine Consultations to Improve Care Quality of Pediatric Hospital-to-Hospital Transfers

远程医疗咨询可提高儿科医院间转院的护理质量

基本信息

批准号：
10403493
负责人：
Jennifer Rosenthal
金额：
$ 16.3万
依托单位：
UNIVERSITY OF CALIFORNIA AT DAVIS
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10403493
关键词：
Accident and Emergency department Address Adherence Award Caregivers Caring Child Childhood Clinical Trials Code Communication Communication Methods Communities Community Hospitals Consult Consultations Critical Illness Data Decision Making Device or Instrument Development Devices Diagnosis Distress Emergency Department patient Emergency department visit Face Family Family Caregiver Family Physicians Future Goals Health Insurance Portability and Accountability Act Health system Hospitalization Hospitals Infrastructure Intensive Care Units Interdisciplinary Study Intervention Leadership Literature Measures Medical Mentors Mentorship Methods National Institute of Child Health and Human Development Nurses Outcome Outcome Measure Parents Patients Pediatric Hospitals Perception Personal Satisfaction Physicians Procedures Protocols documentation Qualitative Methods Quality of Care Research Research Personnel Resources Risk Risk Factors Safety Severity of illness Specific qualifier value Stress Structure Surveys Technology Telemedicine Telephone Testing Time Trauma patient Triage Trust Work acute stress career development cognitive interview design distrust effectiveness testing experience family burden feasibility testing health information technology hospital readmission improved instrument multidisciplinary operation patient safety pediatric emergency pediatric trauma pilot test pilot trial programs psychological trauma randomized trial response shared decision making skills trial comparing trial design uptake usability virtual

项目摘要

PROJECT SUMMARY / ABSTRACT The project objective is to improve care quality by making pediatric transfers more family-centered and effective. This award provides the necessary support to (1) develop skills in instrument development and testing, research leadership, and health information technology (IT) interventions and (2) gather preliminary data to support an R01 application to test the effectiveness of telemedicine consultations for pediatric transfers in a large multi-center randomized trial. I arranged a mentorship team with expertise encompassing instrument development and testing, research leadership, stakeholder engagement, and health IT (telemedicine). The focus of this project is the study of hospital-to-hospital transfers. Transfers pose safety risks to patients as well as burdens and distress to patients and families. Much of this harm is preventable, due to poor information sharing, lack of shared decision-making, and limited ability of the consulting/receiving physician to make transfer triage decisions. The use of telemedicine to provide expert consultation prior to initiating a transfer has potential to mitigate these problems. Telemedicine transforms the communication paradigm to make care during transfers more family-centered. It permits the consulting physician to virtually be at the patient’s bedside, ensuing more collaborative conversations that improve information sharing, shared decision-making, and trust. To effectively improve family-centered care during transfers, we need a validated method to measure this outcome in the context of pediatric emergency department (ED) encounters with children who are thought to need a transfer. Randomized trials are also needed to examine telemedicine use for pediatric transfers. In this proposal, I pursue two Specific Aims: AIM 1: Validate a modified version of an existing instrument that assesses family-centeredness of care in the newly applied context of ED encounters for children in need of transfer. AIM 2: Test the feasibility and potential impact of conducting a randomized trial comparing telemedicine to standard telephone communication for pediatric transfer consultations. This pilot trial utilizes existing UC Davis telemedicine program infrastructure. Feasibility will be tested using specified objectives for protocol adherence, fidelity, and survey response rates. Potential impact will be tested to inform future R01 trial design by exploring responsiveness to the intervention for triage appropriateness outcomes (e.g., potentially avoidable transfers) and patient and family outcomes (e.g., distress). By accomplishing these aims, I will validate an instrument to measure family-centeredness of care that other researchers and health systems can use. Telemedicine is becoming a widely available technology that is increasingly present in emergency departments, so by testing a telemedicine intervention, this project has potential for large-scale uptake. This research will change the communication paradigm for pediatric transfers and help to improve triage appropriateness and patient and family outcomes. This award will help me achieve my long-term goal: to leverage advanced technology to improve the quality of pediatric transitions of care.

项目摘要/摘要