| Autor: |
Shikani BT; General Preventive Medicine Residency Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Hughes HK; Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Office of Telemedicine, Johns Hopkins Medicine, Baltimore, Maryland, USA., Opati E; Office of Telemedicine, Johns Hopkins Medicine, Baltimore, Maryland, USA., Makker K; Division of Neonatology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Gontasz M; Division of Neonatology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Sick-Samuels A; Division of Infectious Diseases, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland, USA. |
| Abstrakt: |
Background: Many neonatal intensive care units (NICUs) lack access to subspecialist consultants and may transfer patients requiring subspecialty care to referral facilities or seek informal consultation. The objective of this work was to evaluate the feasibility, acceptability, and impact of extending pediatric subspecialty services from a children's hospital to a level III NICU via teleconsultation and describe processes, facilitators, and challenges. Methods: Monitored consultations for 1 year and surveyed clinicians regarding feasibility, perceived benefits, and challenges. Results: Fifty-nine teleconsultations were conducted. NICU providers indicated improved care quality with subspecialty input. Subspecialists reported advantages of documenting, billing, and providing more complete care, but noted logistical strains. Both parties perceived better interdisciplinary communication. Conclusions: This teleconsultation service was feasible, generally acceptable, improved access to subspecialty services, and improved NICU clinicians' perceived care quality. Challenges included infrastructure development costs, workflow training time, logistics, and subspecialist patient volumes. This is among the first descriptions of a pediatric subspecialty teleconsultation service supporting a NICU. |
