Error loading player: No playable sources found
Getting the Full Picture: Nurses Find Ways to Incorporate Telehealth Video Visits to Enhance Telephone Triage to Homebound Patients
Research purpose: To utilize office-based nursing staff at a home-based primary care program to pilot use of video visits to enhance telephone triage for homebound patients.
Background: Office-based nursing staff are the initial responders to urgent clinical calls coming into the practice at a large home-based primary care program in New York City. Despite thorough telephone triage, sometimes the clinical picture isn’t fully clear. In order to gather the pertinent clinical information necessary for care planning, the MSVD nursing team initiated the use of video visits into their practice, with the objective of enhancing telephone triage with visualization of the patient. Grant funding was received for a telehealth project in 2020, which included over 100 tablets with 4G connectivity given to patients and introduced two community health workers (CHW) to the program. CHWs made home visits with tablets to facilitate video visits. In response to this new resource, our office-based nursing staff decided to launch a pilot project with the goal of completing same-day video visits for patients who called in with clinical changes where telephone triage alone was not sufficient.
Methods: Retrospective chart reviewed (n=97) analyzing six months of data from January 2022- June 2022 of the patients who received a video visit by the nurse. Quantitative and qualitative data was obtained. Interdisciplinary staff huddles were performed to discuss reasons and triggers for visits and resulting outcomes and benefits.
Results/findings: The most common reason for visits was wound or skin lesion assessment (39.6%), but nurses also performed visits for respiratory assessment (16.8%), heart failure (3.1%), blood pressure monitoring (7.3%), post-fall assessment (1.0%), medication reconciliation (2.1%), and transitional care (19.8%). 61% of the video visits were completed on the same day as the urgent clinical call came in. Nurses noted a broader usefulness of video visits beyond physical assessment including medication reconciliation and transitional care calls. The CHWs were able to assist with technological support, obtaining vital signs, photographing wounds, reconciling medications, and assisting with home environment assessments.
Conclusion/implications: Facilitating video visits may be part of the expanding role of CHWs. Nurses’ innovative use of technology has enhanced the quality of nursing assessment and could be applied to a variety of nursing settings. Telephone triage nursing is a growing field, and adding video visit capability when appropriate could be beneficial for patient care. In this project, nurses intended to address clinical calls with rapid deployment of video visits for timely treatment planning and optimization of care, but we found that video visits can have a broad usefulness in nursing practice including patient education, assessment of home environment, and transitional care management.
Background: Office-based nursing staff are the initial responders to urgent clinical calls coming into the practice at a large home-based primary care program in New York City. Despite thorough telephone triage, sometimes the clinical picture isn’t fully clear. In order to gather the pertinent clinical information necessary for care planning, the MSVD nursing team initiated the use of video visits into their practice, with the objective of enhancing telephone triage with visualization of the patient. Grant funding was received for a telehealth project in 2020, which included over 100 tablets with 4G connectivity given to patients and introduced two community health workers (CHW) to the program. CHWs made home visits with tablets to facilitate video visits. In response to this new resource, our office-based nursing staff decided to launch a pilot project with the goal of completing same-day video visits for patients who called in with clinical changes where telephone triage alone was not sufficient.
Methods: Retrospective chart reviewed (n=97) analyzing six months of data from January 2022- June 2022 of the patients who received a video visit by the nurse. Quantitative and qualitative data was obtained. Interdisciplinary staff huddles were performed to discuss reasons and triggers for visits and resulting outcomes and benefits.
Results/findings: The most common reason for visits was wound or skin lesion assessment (39.6%), but nurses also performed visits for respiratory assessment (16.8%), heart failure (3.1%), blood pressure monitoring (7.3%), post-fall assessment (1.0%), medication reconciliation (2.1%), and transitional care (19.8%). 61% of the video visits were completed on the same day as the urgent clinical call came in. Nurses noted a broader usefulness of video visits beyond physical assessment including medication reconciliation and transitional care calls. The CHWs were able to assist with technological support, obtaining vital signs, photographing wounds, reconciling medications, and assisting with home environment assessments.
Conclusion/implications: Facilitating video visits may be part of the expanding role of CHWs. Nurses’ innovative use of technology has enhanced the quality of nursing assessment and could be applied to a variety of nursing settings. Telephone triage nursing is a growing field, and adding video visit capability when appropriate could be beneficial for patient care. In this project, nurses intended to address clinical calls with rapid deployment of video visits for timely treatment planning and optimization of care, but we found that video visits can have a broad usefulness in nursing practice including patient education, assessment of home environment, and transitional care management.
Learning Objective
- After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.
Speakers
Related Products
Improving Quality of Care for Hypertensive Patients across Seven States through a Competition-Based and Micro-Learning Education Initiative
Purpose: The purpose of this initiative is to improve the quality of care for patients with hypertension by enhancing clinical staff knowledge of blood pressure measurement technique, increasing awareness of the quality metric for hypertension, and implementing a standardized protocol for repeat me…
White-Bagging vs. Free Med vs. Buy & Bill: An Interprofessional Process Improvement Initiative for Neurological Ambulatory Care Infusions
Background: Due to a lack of financial clearance, patients needed to be rescheduled for neurological infusions causing a delay in treatments. 25% had to either be rescheduled or given a free dose paid for by the hospital…
Priority Queue in the Setting of Nurse Triage (Spotlight Poster)
Problem statement: Patients calling to schedule appointments often speak to non-clinical personnel unqualified to offer medical advice. At this call center, there was not an efficient method to transfer callers with designated high-risk symptoms to a registered nurse…
The Institution of a Standardized Telephone Triage Course
Purpose: Within our ambulatory primary care clinics, planning for the ever-changing needs of our patients and communities is a priority of leadership and clinical education. Ambulatory care telephone triage is one of the organization's most rapidly growing and changing specialties…
