Redesigning Primary Care in a Virtual World

Purpose: The purpose of this quality improvement (QI) scholarly project is to describe primary care nurses’ (PCNs) utilization of telehealth in the primary care setting by evaluating a training program for PCNs that supports best practices and promotes efficient care delivery. The sudden onset of the COVID-19 pandemic led to the rapid implementation of telehealth technology in primary care settings, leaving clinicians to quickly adapt essential functions of care delivery with minimal education and training. Telehealth technology provides a cost-effective, efficient alternative for patients to access care from a distance, promoting delivery of the right care, to the right patient, at the right time. Given that telehealth has become a key component of care delivery, understanding PCNs’ perception of telehealth, as well as providing appropriate training, may influence utilization practices in the future. The Learning Objectives are to 1) describe telehealth for primary care delivery, focusing on PCNs and 2) explore PCNs utilization of telehealth to address patient education and integration of telehealth skills and knowledge into practice.

Description: This QI project utilizes a plan-do-study-act framework and will be performed at a non-profit, primary care organization, recognized as a leader in the field of primary care. The project consists of two phases. First, a comparison analysis of PCNs’ telehealth utilization rates, both pre- and post-educational training, will be completed through electronic medical record review to establish baseline and post-implementation criteria. Second, a web-based survey will explore the telehealth practices and program satisfaction among PCNs working in internal medicine for at least one year who participated in a telehealth training program. The survey will be developed and evaluated by a group of expert nurses for content validity, with refinements based on feedback. The final survey will be disseminated through Qualtrics, a web-based program. Descriptive statistics will be used to describe survey results, and free text data will be consolidated into themes regarding suggested recommendations for improving telehealth services.

Evaluation/outcome: This project is currently in progress with expected completion by January 2021. Results will be compiled into an executive summary and professional presentation to be shared among stakeholders consisting of nurses, physicians, and administrative leadership. Results will outline the educational experience and gaps influencing telehealth utilization practices and provide recommendations for future educational and training programs. Through appropriate education and training, PCNs may successfully integrate telehealth practices to positively impact access to care and overall patient outcomes as telehealth care delivery becomes universally available to patients. Better understanding telehealth utilization may serve as a template for other disciplines and care team members across the organization, increasing the value of care to patients.