Increasing Access to Care for Transgender/Gender Diverse Youth Using Telehealth: A Quality Improvement Project

Author(s):  
Meredith R. Russell ◽  
Rebecca L. Rogers ◽  
Stephen M. Rosenthal ◽  
Janet Y. Lee
2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S236-S236
Author(s):  
Laura Perez ◽  
Rebecca Castro ◽  
Steven E Wolf ◽  
Jong Lee

Abstract Introduction Our Burn Center provides care to persons living in southeast area of our State. Patients residing in this area sometimes have low socioeconomic status (SES), and are often unable to return to burn clinic for continued care due to transportation barriers. Typically driving distance is over 80 miles involving ferry access, taking two or more hours each way. The aim of this quality improvement project was to examine the feasibility of a free transportation program for low SES patients who have barriers to transportation. Methods Our first step was to assess transportation needs. We started with a patient survey in clinic to determine if patients would be interested in free transportation and if the service would increase access to care. Survey with six questions was used to assess needs. Results We surveyed ten patients during burn clinic to determine if transportation would increase access to care. Nine patients responded positively and found transportation would be beneficial. One responded that he would not use it as he would use clinic appointment as opportunity to vacation in the area. Funding was secured from our School of Medicine. Community transportation providers were contacted and pricing was obtained. Transportation van was contracted with existing vender. Transportation is now available to patients with burn clinic appointments. We hope to expand to other clinics in the hospital in the future. The Transportation program will assist patients with access to care, compliance, decrease non-emergent Emergency Department visits and 30-day readmissions. Conclusions Transportation assistance for socioeconomically disadvantaged burn patients to follow up in clinic is needed. Nine out of ten patients surveyed were willing to use free transportation. We obtained funding to start a free transportation program once a month. This project began in October 2019. We have begun a once-a-month transportation assistance service to determine ridership and continued need. Twice monthly assistance may be needed and will be assessed over time. Our goal is ultimately to expand the program to include other clinics. Applicability of Research to Practice Free transportation program can assist patients with access to care, compliance, and decrease non-emergent Emergency Department visits and 30-day readmissions.


2016 ◽  
Vol 15 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Laura Melton ◽  
Benjamin Brewer ◽  
Elissa Kolva ◽  
Tanisha Joshi ◽  
Michelle Bunch

AbstractObjective:Young adults with cancer experience high levels of psychological distress. Group interventions for cancer patients have been effective in reducing levels of psychological distress but suffer from high levels of attrition and serve a limited geographic area. In a quality-improvement project, we converted an existing in-person support group to a telemedicine format in the hopes of improving attendance and reducing geographic disparities in access to care.Method:Eight young adults (18–40 years) with cancer were recruited from across Colorado. Participants received a tablet equipped with Wi-Fi and downloaded an HIPAA-compliant video-conferencing application. Participants attended six weekly supportive psychotherapy sessions.Results:Participants found the group to be beneficial: the technology worked, they enjoyed the group format, and they would recommend it to others. The novel treatment interface allowed for low attrition rates due to the flexibility of a patient's location during the intervention. It allowed for provision of services to a geographically diverse population of medically ill young adults, as participants lived an average of 148 miles from the cancer center (range = 25–406 miles).Significance of results:Internet-based mental health care is an area of growing interest for providers, but few studies have evaluated its efficacy in patients with cancer, and even fewer in young adults with cancer. Incorporating technological advances into clinical practice will increase access to care, reduce geographic health disparities, and provide more consistent services.


PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 379A-379A
Author(s):  
Elizabeth A. Parker ◽  
Amber Michelle Rogers Bock ◽  
Tangra L. Broge

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