Telemedicine for Children in Rural Emergency Departments

描述(由申请人提供)：乡村医院通常服务不足 在儿科专科和急救服务方面。因此， 到乡村医院就诊的危重和受伤儿童可能会收到 延迟或不适当的护理。使用远程医疗提供服务不足 设有儿科急救和危重护理远程医疗的医院 磋商没有被描述，以及这些磋商的效果 会对健康的过程、出错频率、结果和成本产生影响 向儿童提供的护理是未知的。此应用程序的目标是 确定远程医疗会诊对质量和 农村危重伤残儿童接受护理的满意度 急诊科。初步数据显示，远程医疗 到乡村医院会诊有助于危重病人的治疗 孩子们。候选人假设急诊儿科远程医疗 会诊到农村，服务不足的急诊科将减少 用药差错的频率；通过以下措施提高护理质量 隐含审查；并减少不必要的病人运送。此外，它还 假设这些部门将被认为质量很高 与控制急诊科相比，没有远程医疗会诊。 将研究两个农村、服务不足的急诊科， 利用远程医疗会诊治疗危重和受伤儿童 (远程医疗教育版)。出现在两人面前的重病和受伤的孩子 配对控制的急诊科(控制ED)将作为控制 研究对象。历史控制数据将从所有四个紧急情况中收集 各部门采用并行配对控制的前测-后测设计 可以使用。加州大学戴维斯分校儿童-S医院重症监护医生将 为农村急诊科提供会诊服务。回顾《 盲目的医疗记录将被用来确定用药错误率， 远程医疗中的隐性质量评估和患者转移率 并控制急诊科。完成的满意度调查 父母/监护人也将在接受治疗的患者之间进行比较 远程医疗和控制急诊科评估效果 远程医疗对患者总体满意度的影响。

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.