Date of Award

Fall 10-12-2022

Degree Type

Dissertation

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

Mary Ellen Roberts, DNP

Advisor

Barnet Eskin, MD

Committee Member

Teresa Conklin, DNP

Keywords

telehealth, access, acute partial, cost, readmissions

Abstract

Abstract

The purpose of this project was to implement an Advance Practice Nurse-led Quality Improvement (QI) initiative to assess telehealth intervention during the Covid-19 pandemic and determine if it increased access to healthcare. This Doctor of Nursing Practice (DNP) project used interventions noted in the literature review to assess effectiveness and acceptance of telehealth use with psychiatric patients to increase access to healthcare in the setting of a medical center. Psychiatric patients often have poor compliance with healthcare visits and treatment due to the challenges of an inability to afford medications, transportation to appointments, poor community support and stigma to receive care. In this project, retrospective observational data were collected and analyzed in the Acute Partial Hospitalization Program (APHP) for psychiatric patients. Data on show rates for initial evaluations/admission to APHP were gathered and analyzed for one year of in-person encounters before the pandemic and a year during pandemic using the intervention of a temporary pilot of telehealth. Data for this QI project showed a 12% and 27% increase, respectively, in the show rate to APHP using “telehealth” or a “mix” of methods per period 1 or 2 as compared to the prepandemic year of “in-person” encounters. The survey data showed that 84% of providers perceived telehealth was satisfactory and effective to use. Data for 30-day readmissions to hospitalization showed a 2.5% increase during the pandemic compared to the prior year, which was not statistically significant. Data showed increased show rates for appointments, with the use of telehealth which has increased access to healthcare.

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