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. 2021 Jun;22(6):1146-1148.e2.
doi: 10.1016/j.jamda.2021.04.009. Epub 2021 Apr 20.

Maximizing Efficiency of Telemedicine in the Skilled Nursing Facility during the Coronavirus Disease 2019 Pandemic

Sabrina P Jen  1 , Albert Bui  2 , Susan D Leonard  3
Affiliations

Maximizing Efficiency of Telemedicine in the Skilled Nursing Facility during the Coronavirus Disease 2019 Pandemic

Sabrina P Jen et al. J Am Med Dir Assoc. 2021 Jun.

Abstract

Telemedicine has rapidly become a significant component of healthcare during the coronavirus disease 2019 pandemic, and is particularly beneficial in delivering care to vulnerable populations in skilled nursing facilities (SNFs). To limit coronavirus disease 2019 exposure, our team developed a quality improvement (QI) project to identify common telemedicine-related disruptions and their solutions, and created a streamlined protocol to maximize the efficiency of virtual rounding in the SNF. Through 9 Plan-Do-Study-Act cycles, we revised our protocol to decrease the percentage of rounding time spent troubleshooting telemedicine-related problems ("nonclinical care time") and were able to demonstrate repeatability at three checkpoints. Our QI project offers a framework for SNF providers and staff to deliver telemedicine-driven patient care.

Keywords: COVID-19; SNF; telehealth; telemedicine.

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Figures

Supplementary Fig. 1
Supplementary Fig. 1
Process map of optimized workflow for virtual rounding after phase 1 which was used in phase 2.
Supplementary Fig. 2
Supplementary Fig. 2
Ishikawa fishbone diagram of causes of inefficient telemedicine rounds.
Supplementary Fig. 3
Supplementary Fig. 3
Data of each telemedicine rounding cycle in phase 1 and phase 2. (A) Proportion of nonclinical care time reduced throughout the study, therefore, increasing the percentage of clinical care time as demonstrated in (B).
See this image and copyright information in PMC

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