Publications [#77080] of Heather E Whitson

Papers Published

1. HE Whitson, SN Hastings, ES McConnell, DA Lekan-Rutledge, Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative., Journal of the American Medical Directors Association, United States, vol. 7 no. 7 (September, 2006), pp. 407-11, ISSN 1525-8610
   (last updated on 2007/07/10)

   Abstract:
   OBJECTIVE: To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. DESIGN: Descriptive pilot project. SETTING: Extended Care and Rehabilitation Center (ECRC), Durham VA Medical Center, Durham, North Carolina. PARTICIPANTS: Eight of 20 registered or licensed practical nurses and 4 of 6 geriatric medicine fellows voluntarily participated in this quality improvement project. MEASUREMENTS: In two 45-minute focus groups, participants were asked to discuss 3 open-ended questions related to telephone medicine. Comments were recorded during the discussions; topical themes were identified by the authors. RESULTS: Participant comments could be categorized into 4 domains describing the characteristics of nurses and physicians who practice the best telephone medicine: (1) provides the appropriate medical component of patient care; (2) appreciates contextual issues; (3) respects the other party's time and resources; and (4) possesses a collaborative attitude. The focus groups identified 5 quality improvement goals: (1) better nursing assessment and provision of patient information; (2) minimization of non-urgent calls after hours; (3) more decisive physician action (or explanation of inaction); (4) better physician familiarity with facility policies/logistics; and (5) better communication/paging system. The discussion format allowed nurses and physicians to identify and respond to potential barriers to improving quality in each area. CONCLUSION: Nurses and physicians appreciate unique aspects of long-term care telephone medicine and identify distinct barriers to improving practice. Interdisciplinary focus groups were a productive step toward understanding the telephone medicine experience in our facility and developing quality improvement interventions for both nurses and physicians.

   Keywords:
   After-Hours Care • Attitude of Health Personnel* • Clinical Competence • Cooperative Behavior • Emergency Medical Service Communication Systems • Focus Groups • Geriatric Nursing • Geriatrics • Goals • Health Services Needs and Demand • Humans • Long-Term Care • Medical Staff • North Carolina • Nursing Assessment • Nursing Staff • Patient Care Team • Patient Education • Pilot Projects • Questionnaires • Rehabilitation Centers • Telemedicine • Telephone • Total Quality Management • methods* • organization & administration* • psychology • standards • standards*