Abstract
Objective:Telerehabilitation has long been recognized as a promising means of providing pediatric services; however, significant barriers such as cost, payor reimbursement, and access prevented widespread use. The advent of the COVID-19 pandemic necessitated rapid adoption of telerehabilitation into clinical practice to provide access to care while maintaining social distancing. The purpose of this study is to present clinical data on the feasibility and acceptability of speech-language pathology, developmental occupational and physical therapies, and sports and orthopedic therapies telerehabilitation delivered in a pediatric hospital setting.Methods:Telerehabilitation services were rapidly implemented in three stages: building the foundation, implementing, and refining this service delivery model. Paper patient satisfaction surveys were administered as part of ongoing quality improvement efforts throughout 2019 and were adapted for online administration in 2020 for telerehabilitation patients. Outpatient visit counts by type (in-person, phone, and video) were extracted from the electronic medical record using data warehousing techniques.Results:Historical patient satisfaction rates from 2019 indicated high patient satisfaction (98.97% positive responses); these results were maintained for telerehabilitation visits (97.73%), indicating that families found telerehabilitation services acceptable. Patient volume returned to 73.5% of pre-pandemic volume after the implementation of telerehabilitation services.Conclusions:Pediatric telerehabilitation is feasible to provide in clinical settings, and the services are acceptable to patient families. Future work is needed to evaluate the impact of telerehabilitation services on patient care and applications for ongoing use of this delivery model.
Highlights
MethodsSETTINGThis study took place in a large, free-standing pediatric hospital in the Midwest that draws patients from urban, suburban, and rural locations
The purpose of this study is to present clinical data on the feasibility and acceptability of speech-language pathology, developmental occupational and physical therapies, and sports and orthopedic therapies telerehabilitation delivered in a pediatric hospital setting
The Sports and Orthopedic Therapies Department quickly saw a reduction in in-person visits due to multiple factors, including decreased pediatric involvement in sports based on the stay-at-home order, a decline in surgeries based on the halting of elective surgeries, and a general reduction in “non-essential” hospital visits; this department was able to implement telerehabilitation services starting in the week after the stay-at-home order was issued
Summary
SETTINGThis study took place in a large, free-standing pediatric hospital in the Midwest that draws patients from urban, suburban, and rural locations. The Division of Clinical Therapies includes multiple outpatient therapy departments employing a total of 221 full-time equivalents in both clinical and non-clinical staff members Across all of these outpatient departments, 4,500 patients per week were seen for outpatient therapy visits prior to the COVID-19 pandemic, across 24 outpatient buildings. The Sports and Orthopedic Therapies Department quickly saw a reduction in in-person visits due to multiple factors, including decreased pediatric involvement in sports based on the stay-at-home order, a decline in surgeries based on the halting of elective surgeries, and a general reduction in “non-essential” hospital visits; this department was able to implement telerehabilitation services starting in the week after the stay-at-home order was issued. The Developmental OT and PT Department followed a thoughtful approach to initiating telerehabilitation, beginning their first telerehabilitation visits two weeks after the initial onset of visits completed by the Speech Pathology Department.
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