Clinical Services

ePoster Presentation

(EP-116) Increasing Utilization Through Nurse Engagement in a School-based Telemedicine Program

Monday, April 24
5:45 PM - 5:59 PM
Location: Experience Zone - ePosters

Objectives
1. Describe the community-based collaborative partnership between the school-based telemedicine program and school nurses
2. Recognize the need for fully engaging the telepresenter to optimize program success
3. Discuss the ways school nurses can become more engaged in their role as telepresenter
4. Discuss the success of the program through nurse satisfaction and utilization


Methods
School-based telehealth programs often employ and provide Telehealth presenters that work directly for the program itself, thus creating little disruption to the typical workflow of the school nurse. Our program includes a collaborative partnership with existing school nurses, who function as the Telehealth presenter. Our program originally started with 27 schools, primarily in urban and rural areas. Because the utilization was low in the first year, we implemented targeted interventions to boost school nurses’ engagement with the program with hopes of increasing usage and overall encounters. The interventions, driven by physicians and administrators, included face-to-face meetings between the nurses and providers and additional engagement activities (e.g., nurse’s forum, webinars). The program’s operational outcomes were evaluated based on program utilization along with nurse and parent satisfaction.

Results
While the program expanded from 27 schools to 57 schools from 2014-2015 and 2015-2016 school years, the encounters increased across the board for each school. For the first 27 schools, the total encounters increased from 222 (2014-2015) to 1,994 (2015-2016), reflecting an eightfold increase in utilization. These increases were sustained to the next 30 schools that opened in the 2015-2016 school year, resulting in 3,636 total virtual visit consultations for that school year. In assessing usage, satisfaction surveys were deployed to nurses on a semester basis. On average (out of a 5-point scale), nurses reported high levels of satisfaction with the program (4.7), the service being an alternative to the ED visits (3.8), the program reducing illness-related absenteeism (4.2), and being a valuable resource to them (3.9), the student (3.9), the parent (3.9), and the school (3.9).

Conclusion
Nurse engagement is a key component to the success of a school-based telehealth program. Rapport takes time to build. Our findings suggest that boosting the nurses’ overall feeling that they are a part of the program and highlighting the benefits of the program for the nurses, students, parents, and the school may potentially impact utilizations. The findings from the school nurse survey suggest that from a school nurse perspective, the school-based telehealth program is an enhancement to the practice of school nursing. The impact or outcome of the program on system usage, absenteeism, and time saved requires further evaluation.

Stormee Williams

Medical Director, School Telemedicine
Children's Health System of Texas

Stormee Williams, M.D., is a board-certified pediatrician who has practiced in the Dallas area for over 10 years. Since completing her residency at Children’s Medical Center Dallas, Dr. Williams has served in the Dallas area as a general pediatrician, working primarily with underserved patient populations from birth to age 18. She has worked for a Federally Qualified Health Center in Dallas and has functioned as the Lead Physician in community health clinics for both Parkland Health and Hospital Systems and Children’s Health Systems of Texas. Dr. Williams began working in telemedicine in 2013 and currently serves as the Medical Director for School-based Telemedicine for Children’s Health System of Texas.

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(EP-116) Increasing Utilization Through Nurse Engagement in a School-based Telemedicine Program



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