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Implementation of an emergency department virtual follow-up care process in a community-based hospital: a quality improvement initiative
During the COVID-19 pandemic, patients were apprehensive to seek acute care resulting in delayed diagnoses of serious conditions and reduction in emergency room (ER) visits by 50% in the Fraser Health Authority. Patients who did present to the ER left prior to their results being available and some...
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Published in: | BMJ open quality 2022-04, Vol.11 (2), p.e001782 |
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Main Authors: | , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | During the COVID-19 pandemic, patients were apprehensive to seek acute care resulting in delayed diagnoses of serious conditions and reduction in emergency room (ER) visits by 50% in the Fraser Health Authority. Patients who did present to the ER left prior to their results being available and some refused admission and critical treatments.At the Chilliwack General Hospital ER, a virtual care clinic was established to follow-up on patients after their initial ER visit, providing test results and ensuring patients are not clinically deteriorating at home. Specific criteria were created for safe referral to virtual follow-up. For 2 hours daily, an ER physician contacts selected patients by telephone to provide a virtual follow-up based on the patients’ needs.Through the emergency department virtual care (EVC) pilot project, from May 14 to August 31, 2020, on average 58 telehealth visits were conducted weekly, with 19% of visits reaching unattached patients without a regular primary care provider. A patient survey revealed that 75% of respondents were very satisfied or satisfied with telephone virtual care as a follow-up to their emergency department (ED) visit, while 95% would like to continue to receive telephone follow-up care. Additionally, based on a physician survey, 80% of providers were satisfied or very satisfied with the overall EVC experience. The majority (80%) would like to continue to provide the service. One patient was referred for a virtual care follow-up for imaging results that did not meet the referral criteria; the patient was diagnosed with a perforated appendicitis. They had an atypical presentation of abdominal pain and their care was delayed by several hours than if they were to present to the ED for in-person follow-up. The process and referral criteria may require minor modification and must be followed strictly to ensure safety and efficiency in providing telehealth follow-up in the acute care setting. |
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ISSN: | 2399-6641 2399-6641 |
DOI: | 10.1136/bmjoq-2021-001782 |