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IntroductionHealthcare providers and systems increasingly utilize telehealth modalities to address barriers and challenges for healthcare delivery. Specialties, such as psychiatry, are testing asynchronous methods for telehealth delivery. The National Quality Forum (NQF) developed a framework with which to assess the quality of telemedicine according to measures and measure concepts within four domains. This review assesses existing asynchronous telepsychiatry (ATP) research according to the telehealth domains established by NQF, evaluates the prevalence and quality of ATP, and identifies the areas in which more research must be conducted. MethodsA systematic review of ATP methods was conducted according to PRISMA guidelines. Studies were categorized according to NQF telehealth domains and subdomains to further examine study outcomes. ResultsThe review initially identified 205 studies that were narrowed down to a final sample of 11 articles. Of the final articles, most studies addressed the effectiveness of ATP or users’ experience with ATP. DiscussionThe initial investigation of published ATP literature suggests promising results. ATP studies suggest that these services improve access to care, can be feasibly implemented by the clinical team, maintain patient/family satisfaction, and potentially reduce the cost of services. The limited sample of published literature necessitates further study of the practice in order to assess ATP according to the quality domains identified by NQF, especially access to care for patients and caregivers, the financial costs incurred by both providers and patients, and barriers to uptake.
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Classification strategies for non‐routine events occurring in high‐risk patient care settings: A scoping review
Abstract IntroductionNon‐routine events (NREs) are atypical or unusual occurrences in a pre‐defined process. Although some NREs in high‐risk clinical settings have no adverse effects on patient care, others can potentially cause serious patient harm. A unified strategy for identifying and describing NREs in these domains will facilitate the comparison of results between studies. MethodsWe conducted a literature search in PubMed, CINAHL, and EMBASE to identify studies related to NREs in high‐risk domains and evaluated the methods used for event observation and description. We applied The Joint Commission on Accreditation of Healthcare Organization (JCAHO) taxonomy (cause, impact, domain, type, prevention, and mitigation) to the descriptions of NREs from the literature. ResultsWe selected 25 articles that met inclusion criteria for review. Real‐time documentation of NREs was more common than a retrospective video review. Thirteen studies used domain experts as observers and seven studies validated observations with interrater reliability. Using the JCAHO taxonomy, “cause” was the most frequently applied classification method, followed by “impact,” “type,” “domain,” and “prevention and mitigation.” ConclusionsNREs are frequent in high‐risk medical settings. Strengths identified in several studies included the use of multiple observers with domain expertise and validation of the event ascertainment approach using interrater reliability. By applying the JCAHO taxonomy to the current literature, we provide an example of a structured approach that can be used for future analyses of NREs.
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- Award ID(s):
- 1763355
- PAR ID:
- 10453633
- Publisher / Repository:
- Wiley-Blackwell
- Date Published:
- Journal Name:
- Journal of Evaluation in Clinical Practice
- Volume:
- 27
- Issue:
- 2
- ISSN:
- 1356-1294
- Page Range / eLocation ID:
- p. 464-471
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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