Abstract:
INTRODUCTION:Over the past several years there has been a dramatic increase in the implementation of telemedicine technology to aid in the delivery of care across community, inpatient, and emergency settings. This technology has proved valuable for acute life-threatening clinical scenarios. We aimed to pilot a novel neurosurgical telemedicine program within an academic tertiary care center to assist in consultation of patients with high-grade intracranial hemorrhage (ICH) (ICH score 4, 5). METHODS:A quality improvement conceptual framework was developed. Subsequently, a process map and improvement interventions were created. Patients in community hospitals with high-grade ICH or pre-existing Do Not Resuscitate/Do Not Intubate orders with an admitting diagnosis of ICH triggered a TeleNeurosurgery consultation. Patients who met the inclusion criteria, with consent of their decision makers, were enrolled in the study. Post-encounter physician surveys were used to evaluate overall satisfaction with the implementation. RESULTS:This 18-month pilot study proved feasible, with an enrollment of 63.6% (n = 14 of 22) of patients who met criteria. All patients who were enrolled in the study and participated in TeleNeurosurgery consultation remained at the presenting facility for end-of-life care and palliative medicine consultation. Both community emergency physicians and subspecialists who performed the consultations reported satisfaction with the TeleNeurosurgery consultation process and a perceived benefit both to patients, families, and emergency medicine physicians. CONCLUSIONS:The program proved feasible and several areas in need of improvement within the health system were identified. Emergency physicians reported comfort with the process, program effectiveness, and improved access to care by implementation of this program.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Wright J,Gerges C,Shammassian B,Zhou X,Huang Wright C,Duan Y,Cabrera CI,Rosenfeld K,D'Anza B,Pronovost P,Sajatovic M,Bambakidis Ndoi
10.1016/j.wneu.2020.12.010subject
Has Abstractpub_date
2020-12-10 00:00:00eissn
1878-8750issn
1878-8769pii
S1878-8750(20)32574-2pub_type
杂志文章abstract:BACKGROUND:Dissection of brain surface adhesions during recurrent glioma surgery carries a risk of injury to cortical vessels and important surface vessels. We present our experience with the use of BioD film, a biocompatible amniotic membrane implant, to help prevent postoperative adhesions. We describe a novel method...
journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.119
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journal_title:World neurosurgery
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.113
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2018.01.139
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pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.08.010
更新日期:2016-11-01 00:00:00
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.129
更新日期:2016-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.212
更新日期:2019-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.04.006
更新日期:2010-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.02.010
更新日期:2011-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
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更新日期:2016-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.11.255
更新日期:2019-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.151
更新日期:2021-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.001
更新日期:2020-12-01 00:00:00
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更新日期:2016-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.12.042
更新日期:2017-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2020-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.134
更新日期:2019-06-01 00:00:00
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journal_title:World neurosurgery
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更新日期:2020-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2020-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2019-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-05-01 00:00:00