Jennifer Hensel1,2, Reid Graham1, Corinne Isaak3, Naweed Ahmed4, Jitender Sareen1,5, James Bolton1,5. 1. Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. 2. Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, Ontario, Canada. 3. MBTelehealth, Winnipeg, Manitoba, Canada. 4. Department of Family Practice, University of British Columbia, Victoria, British Columbia, Canada. 5. Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
OBJECTIVES: To report on the perceived barriers surrounding the use of telepsychiatry for emergency assessments and our approach to overcoming those barriers to achieve successful implementation of a program to increase access to emergency psychiatric assessment in a Canadian urban setting. METHODS: We conducted a survey of emergency care staff to inform the implementation of an emergency telepsychiatry program in the urban setting of Winnipeg, Manitoba, where hospitals have variable on-site emergency psychiatric coverage. We analyzed survey responses for perceived barriers we would need to address in implementation. We employed implementation strategies for each barrier and scaled the program to three sites over the first year. Data from the first year were collected including number of telepsychiatry assessments, reasons for referral, wait time, and percentage of patient transfers avoided. RESULTS: Survey respondents (N = 111) had little prior exposure to telepsychiatry, but the majority were open to its use for emergency psychiatric assessments in the region. We identified three categories of perceived barriers: clinical, logistical/technical, and readiness barriers. Implementation planning addressed each barrier, and a hub-and-spoke program was launched. After the first year, the program had one hub serving three spokes, and 243 emergency telepsychiatry assessments had been completed. After 12 months, we were avoiding 65% of patient transfers. CONCLUSIONS: By conducting a user survey to identify perceived barriers, and addressing these during implementation, we successfully scaled our emergency telepsychiatry program across our region. Our report of this experience may benefit others attempting to implement a similar program.
OBJECTIVES: To report on the perceived barriers surrounding the use of telepsychiatry for emergency assessments and our approach to overcoming those barriers to achieve successful implementation of a program to increase access to emergency psychiatric assessment in a Canadian urban setting. METHODS: We conducted a survey of emergency care staff to inform the implementation of an emergency telepsychiatry program in the urban setting of Winnipeg, Manitoba, where hospitals have variable on-site emergency psychiatric coverage. We analyzed survey responses for perceived barriers we would need to address in implementation. We employed implementation strategies for each barrier and scaled the program to three sites over the first year. Data from the first year were collected including number of telepsychiatry assessments, reasons for referral, wait time, and percentage of patient transfers avoided. RESULTS: Survey respondents (N = 111) had little prior exposure to telepsychiatry, but the majority were open to its use for emergency psychiatric assessments in the region. We identified three categories of perceived barriers: clinical, logistical/technical, and readiness barriers. Implementation planning addressed each barrier, and a hub-and-spoke program was launched. After the first year, the program had one hub serving three spokes, and 243 emergency telepsychiatry assessments had been completed. After 12 months, we were avoiding 65% of patient transfers. CONCLUSIONS: By conducting a user survey to identify perceived barriers, and addressing these during implementation, we successfully scaled our emergency telepsychiatry program across our region. Our report of this experience may benefit others attempting to implement a similar program.
Authors: Trisha Greenhalgh; Joseph Wherton; Chrysanthi Papoutsi; Jennifer Lynch; Gemma Hughes; Christine A'Court; Susan Hinder; Nick Fahy; Rob Procter; Sara Shaw Journal: J Med Internet Res Date: 2017-11-01 Impact factor: 5.428
Authors: Sonia Johnson; Christian Dalton-Locke; John Baker; Charlotte Hanlon; Tatiana Taylor Salisbury; Matt Fossey; Karen Newbigging; Sarah E Carr; Jennifer Hensel; Giuseppe Carrà; Urs Hepp; Constanza Caneo; Justin J Needle; Brynmor Lloyd-Evans Journal: World Psychiatry Date: 2022-06 Impact factor: 79.683