Support My Spine ASAP. A Rural Tele-health care model for patients being managed with a Thoracic Lumbar Sacral Orthotic (TLSO)

R. Gallagher, J. Morison, M. Giles, Judith Henderson, S. Zehnder
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Abstract

Abstract Question Does a Telehealth model of care facilitating treatment in rural hospitals for patients requiring a TLSO eliminate the need for transfer to a tertiary referral hospital? Design Quantitative pre and post intervention design. Participants Physiotherapists, nursing and medical staff at rural hospital pilot sites. Intervention Pre and post intervention data collection provided patient demographics, and length of stay data around model of care implementation. Pre intervention staff surveys identified knowledge gaps informing educational packages which were provided with a mobile Telehealth link. Outcome measures Primary: Number of patients managed under the new model of care. Secondary: Length of stay, travel distance eliminated and complications. Results 30 patients fitted with TLSO’s and managed under this model of care to date. Length of stay has reduced from 9.14 days pre intervention to 3.8 days post intervention. Approximate savings of $6840 per patient have been identified, with over 6000kms of patient travel eliminated. No complications have occurred. Rural Physiotherapists have been successfully up skilled in managing patients requiring TLSO fitting. Conclusion This intervention successfully created a model of care to facilitate local management of patients requiring TLSO fitting with Telehealth support from a tertiary referral hospital. Considerable savings have occurred from this model of care for patients and the health district. This model is currently being implemented district wide. Key Practice Points Telehealth model of care can be successfully implemented to TLSO management Multidisciplinary team role is critical role in redesigning models of care Telehealth increase the efficiency of healthcare resources
尽快支持我的脊椎。采用胸腰椎骶骨矫形器(TLSO)治疗的农村远程保健模式
远程医疗模式是否有助于农村医院对需要TLSO的患者进行治疗,从而消除了转到三级转诊医院的需要?定量干预前后设计。参与者:农村医院试验点的物理治疗师、护理人员和医务人员。干预前和干预后的数据收集提供了患者人口统计数据,以及围绕护理实施模式的住院时间数据。干预前工作人员调查确定了与移动远程保健连接提供的一揽子教育有关的知识差距。主要指标:在新护理模式下管理的患者数量。次要因素:住院时间、消除旅行距离和并发症。结果30例患者安装了TLSO,并在此护理模式下进行管理。住院时间从干预前的9.14天减少到干预后的3.8天。每名患者大约可节省6840美元,省去了6000多公里的患者路程。无并发症发生。农村物理治疗师已经成功地熟练地管理需要TLSO安装的患者。结论:该干预措施成功地创建了一种护理模式,以促进对需要TLSO的患者的本地管理,并与三级转诊医院的远程医疗支持相结合。这种对病人和卫生区的护理模式节省了大量资金。这一模式目前正在全区范围内实施。远程医疗模式可以成功实施到TLSO管理中,多学科团队的作用是重新设计远程医疗模式的关键,提高了医疗资源的效率
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