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Ambulatory Virtual Care During a Pandemic: Patient Safety Considerations.

Publication ,  Journal Article
Mullur, J; Chen, Y-C; Wickner, P; Licurse, A; Desai, S
Published in: J Patient Saf
March 1, 2022

BACKGROUND: The COVID-19 pandemic prompted sudden and fundamental changes in health care, including a rapid rise in the utilization of telehealth services in the ambulatory setting. With the unprecedented and significant decline in traditional office-based visits and procedures, novel patient safety risks and challenges emerged. METHODS: The ambulatory practices at our quaternary care, academic medical center experienced a 200-fold increase in virtual visit volume between February and April 2020. We convened a multidisciplinary working group dedicated to evaluating quality and safety when providing virtual visits during a pandemic. Our primary outcome was patient experience with virtual care delivery, which was assessed by leveraging patient complaint data and patient satisfaction survey data. RESULTS: For our main focus of patient experience and satisfaction, survey data were analyzed from the approximately 76,616 virtual visit encounters that occurred between March 1, 2020, and April 21, 2020. During this period, 5 patient complaints were filed to the Patient Advocacy Department. Overall, patient satisfaction with telehealth remained stable and high at >93% from February to May 2020. As we assessed these data each month, our working group developed risk mitigation strategies in response to the novel challenges presented by the use of telemedicine due to the COVID-19 pandemic while working to maintain patient satisfaction with care. We identified quality and safety issues around patient factors including optimal triage of patients and use of technology. We also evaluated accessibility to virtual platforms and logistics such as coordination of care for diagnostic testing. Finally, a guidance document was created and communicated to our diverse ambulatory practices to support clinicians. CONCLUSIONS: Ambulatory virtual care delivery requires a dynamic, flexible model of care through continuous rapid-cycle process improvement to mitigate patient safety risks during a pandemic, incorporating both provider and patient perspectives.

Duke Scholars

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Published In

J Patient Saf

DOI

EISSN

1549-8425

Publication Date

March 1, 2022

Volume

18

Issue

2

Start / End Page

e431 / e438

Location

United States

Related Subject Headings

  • Telemedicine
  • SARS-CoV-2
  • Patient Satisfaction
  • Patient Safety
  • Pandemics
  • Humans
  • Health Policy & Services
  • COVID-19
  • Ambulatory Care
  • 4203 Health services and systems
 

Citation

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Mullur, J., Chen, Y.-C., Wickner, P., Licurse, A., & Desai, S. (2022). Ambulatory Virtual Care During a Pandemic: Patient Safety Considerations. J Patient Saf, 18(2), e431–e438. https://doi.org/10.1097/PTS.0000000000000832
Mullur, Jyotsna, Yih-Chieh Chen, Paige Wickner, Adam Licurse, and Sonali Desai. “Ambulatory Virtual Care During a Pandemic: Patient Safety Considerations.J Patient Saf 18, no. 2 (March 1, 2022): e431–38. https://doi.org/10.1097/PTS.0000000000000832.
Mullur J, Chen Y-C, Wickner P, Licurse A, Desai S. Ambulatory Virtual Care During a Pandemic: Patient Safety Considerations. J Patient Saf. 2022 Mar 1;18(2):e431–8.
Mullur, Jyotsna, et al. “Ambulatory Virtual Care During a Pandemic: Patient Safety Considerations.J Patient Saf, vol. 18, no. 2, Mar. 2022, pp. e431–38. Pubmed, doi:10.1097/PTS.0000000000000832.
Mullur J, Chen Y-C, Wickner P, Licurse A, Desai S. Ambulatory Virtual Care During a Pandemic: Patient Safety Considerations. J Patient Saf. 2022 Mar 1;18(2):e431–e438.

Published In

J Patient Saf

DOI

EISSN

1549-8425

Publication Date

March 1, 2022

Volume

18

Issue

2

Start / End Page

e431 / e438

Location

United States

Related Subject Headings

  • Telemedicine
  • SARS-CoV-2
  • Patient Satisfaction
  • Patient Safety
  • Pandemics
  • Humans
  • Health Policy & Services
  • COVID-19
  • Ambulatory Care
  • 4203 Health services and systems