A 360 Evaluation of Neonatal Care Quality at a Level II Neonatal Intensive Care Unit when Delivered Using a Hybrid Telemedicine Service

Henry G. Hallford; Edgardo Szyld; Michael McCoy; Abhishek Makkar

doi:10.1055/a-1932-9921

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2024; 41(S 01): e711-e718
DOI: 10.1055/a-1932-9921

Original Article

A 360 Evaluation of Neonatal Care Quality at a Level II Neonatal Intensive Care Unit when Delivered Using a Hybrid Telemedicine Service

Henry G. Hallford

¹Department of Pediatrics, Section of Neonatal and Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

,

Edgardo Szyld

¹Department of Pediatrics, Section of Neonatal and Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

,

Michael McCoy

¹Department of Pediatrics, Section of Neonatal and Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

,

Abhishek Makkar

¹Department of Pediatrics, Section of Neonatal and Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

› Institutsangaben

Abstract

Objective In 2013, the Section of Neonatal and Perinatal Medicine at the University of Oklahoma's Children's Hospital began providing advanced care to a regional level II neonatal intensive care unit (NICU), using a hybrid telemedicine program. This project compares health care providers' and parents' assessments of health care quality using this program.

Study Design This is a prospective, anonymous, nonrandomized survey of health care providers and parents of neonates using our hybrid telemedicine services. Physicians, neonatal nurse practitioners (NNPs), nurses, and parents completed pencil-and-paper surveys based on their participatory roles. Institutional Review Board approval was obtained at OU Medical Center and Comanche County Memorial Hospital. Surveys consisted of 5-point Likert's scale questions. Descriptive statistics compared the level of agreement with each question across participant groups. A service quality (SQ) composite score was created by summing responses from six SQ questions. Between-group analysis was done on the SQ score using the Mann–Whitney U-test.

Results Nine physicians, 10 NNPs, 12 nurses, and 40 parents completed the survey. Providers agreed (90%) that telemedicine can effectively deliver advanced neonatal care; the care patients receive is comparable to direct patient care (87%); telemedicine enhanced overall patient care quality (90%); providers can effectively interact with each other and families using telemedicine (90.3%), and overall telemedicine experience was good (90%). In total, 61% of providers reported telemedicine improves physician-patient interaction. Parents of newborns agreed that they were well informed about telemedicine use for their child's care (88%), were able to communicate routinely with neonatologists (85%), and were comfortable with their child's physical examinations (93%). Provider's versus family's (SQ) score was not significantly different.

Conclusion All survey participants, including neonatologists, NNPs, nurses, and patient families, reported high levels of satisfaction with the hybrid telemedicine model developed and implemented at this institution which may be comparable to in-person direct patient care.

Key Points

Implementation of a hybrid telemedicine system provides an alternative to the transfer of newborns needing advanced care to tertiary care facilities.
In this study, both health care providers and patient family members were satisfied with the quality of care using hybrid telemedicine.
In this study, families of newborns could fully participate in their child's care using the hybrid telemedicine system.

Keywords

e-Health - telemedicine - teleneonatology - neonatal nurse practitioner - service delivery model - satisfaction survey - advanced neonatal care

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Referenzen

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