Journal article
Implementation of Telehealth for Psychiatric Care in VA Emergency Departments and Urgent Care Clinics
Telemedicine journal and e-health, Vol.28(7), pp.985-993
11/16/2021
DOI: 10.1089/tmj.2021.0263
PMCID: PMC9469744
PMID: 34788149
Abstract
Objective: To conduct a mixed-methods evaluation of an emergency telehealth intervention in unscheduled settings (emergency department [ED] and urgent care clinic [UCC]) within the Veterans Health Administration (VHA).Materials and Methods: We used the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to conduct a mixed-methods evaluation of a novel telehealth program implemented in the VHA (Hospital System) in March 2020. We compared the 3 months preimplementation (December 1, 2019 through February 29, 2020) with the 3 months postimplementation (April 1, 2020 through June 30, 2020), then followed sustainability through January 31, 2021. Qualitative data were obtained from surveys and semistructured interviews of staff and providers and analyzed with thematic analysis.Results: Patient demographics and dispositions were similar pre- and postimplementation. The telemental health intervention was used in 319 (83%) unscheduled mental health consultations in the postimplementation phase. After implementation, we did not detect adverse trends in length of stay, 7-day revisits, or 30-day mortality. Use remained high with 82% (n = 1,010) of all unscheduled mental health consultations performed by telemental health in the sustainability phase. Staff and clinician interviews identified the following themes in the use of telemental health: (1) enhanced efficiency without compromising quality and safety, (2) initial apprehension, (3) the COVID-19 pandemic, and (4) sustainability after resolution of the COVID-19 pandemic.Conclusions: This mixed-methods evaluation of unscheduled telemental health implementation found that its use was feasible, did not impact the safety and efficacy of mental health consultations, and was highly acceptable and sustainable in unscheduled settings.
Details
- Title: Subtitle
- Implementation of Telehealth for Psychiatric Care in VA Emergency Departments and Urgent Care Clinics
- Creators
- Michael J. Ward - Vanderbilt University Medical CenterJohn L. Shuster - VA Tennessee Valley Healthcare SystemNicholas M. Mohr - Iowa City VA Health Care SystemPeter J. Kaboli - Iowa City VA Health Care SystemAmanda S. Mixon - Vanderbilt University Medical CenterJennifer Kemmer - VA Tennessee Valley Healthcare SystemCorey Campbell - VA Tennessee Valley Healthcare SystemCandace D. McNaughton - Vanderbilt University Medical Center
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.28(7), pp.985-993
- DOI
- 10.1089/tmj.2021.0263
- PMID
- 34788149
- PMCID
- PMC9469744
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Publisher
- Mary Ann Liebert, Inc
- Number of pages
- 9
- Grant note
- K08 HS025753 / AHRQ HHS; United States Department of Health & Human Services; Agency for Healthcare Research & Quality
- Language
- English
- Date published
- 11/16/2021
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984295922402771
Metrics
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