Virtual Team Collaboration on Home Health Care, Golden Jubile ...

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Abstract

Telemedicine has the potential to improve access to health care services, especially for dependent and bedridden patients. Since Golden Jubilee Medical Center is a university hospital whose mission includes leading innovation, we developed a virtual team to improve access to home health care. This work included developing a model and assessing collaboration, the critical success factor of effective teamwork. The virtual team worked in parallel to their routine home service and consisted of six physicians at three hospitals, two nurses, and one driver. Departments that supported this initiative were inpatient and emergency, pharmacy, nutrition, and finance. The team home-visited every business day and a nurse was in charge of 24/7 telephone calls for consultation. Patient data were recorded in Ninox@ on iCloud@ and communication was via Slack@ and Line@ for clinical and general information respectively. After ethics approval, the study retrospectively collected home visit data over six months, counted consensus-based decision-makings/SBAR (situation-background-assessment-recommendation) as an indicator of collaboration, and analyzed any impact factor involving face-to-face meetings and family satisfaction by an interactive diagram on both individual and systematic multi-team levels. Results of 430 visits of ninety-six patients with chronic wound (36), palliative care (30), physical therapy (31) and follow-up post discharge (29), revealed a range of zero to six decision-making/SBARs per month, or 47–69.6 percent of all communications, and three times of Line@. The family rated satisfaction scores are high. Virtual team operation did not affect health care outcome in terms of emergency room revisits or delays in admission. We concluded that the model was cost-effective, but better collaboration assessment might be considered together with a multi-team concept at the organizational level.