The following article is part of coverage from the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2020). Due to the global COVID-19 pandemic, the Association made the necessary decision to cancel their meeting originally scheduled for March 25-28, 2020, in Long Beach, CA, and rescheduled the event to a virtual meeting held June 4-5, 2020. Readers can click here to catch up on the latest research.
A virtual care program for pediatric patients with medical complexity improves patient and family quality of life as well as reduces unnecessary emergency department visits and hospitalizations, according to research presented virtually at the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2020).
The vKids at Home program uses a physician-led virtual clinical team and home monitoring technology to manage medically complex ambulatory pediatric patients, reported Cheryl L. Grave, RN, CPNP, a pediatric nurse practitioner at Mercy Virtual Kids in St. Louis, Missouri. Patients aged <18 years who had a medically complex condition, had visited the emergency department or were hospitalized ≥3 times in the past 12 months were included. Infants were included if they were discharged from the neonatal intensive care unit with complex needs and/or high risk for emergency department of hospitalization within 6 months.
Each home kit contained a pulse oximeter, blood pressure cuff, scale, thermometer, and iPad with software. Patients or their guardian were to complete a daily check-in using the iPad, with the ability to escalate to text message, phone, or video visit with any of the members of the care team (nurse, nurse practitioner, social worker, and physician).
In the first year, the vKids team enrolled 89 patients in the program; patients had an average of 4.3 emergency department visits and 2.5 hospitalizations per patient in the 12 months prior to enrollment. After implementation of the program, the patients had a 42% reduction in emergency department and a 26% reduction in inpatient admissions. At the 1-year analysis, the team identified 86 documented instances where the vKids team helped a patient avoid an unnecessary emergency department visit.
Overall, the program had a 91.4% satisfaction rating. The vKids team also helped support the transition of 4 medically complex patients into foster care. The program also provided support and direction in a critical situation by giving life-saving care via video and facilitating safe transition to the hospital.
“Our model of a physician-led multidisciplinary virtual team allows every member to build trust with the families and home nurses caring for complex kids,” concluded Ms Grave. “This relationship leads to significant opportunity to provide support by engaging through digital surveys, texting, phone and video visits.”
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Grave CL. Telehealth for Complex Pediatric Patients at Home. Presented virtually at: NAPNAP 2020; June 4-5, 2020. Abstract TH7.