A Human Factors Assessment of the Impact of Telehealth Implementation on Nurses during the COVID Pandemic.
Event Type
Oral Presentations
TimeWednesday, June 8th3:30pm - 4:00pm EDT
DescriptionBackground: The COVID-19 pandemic accelerated telehealth adoption across inpatient settings to support care delivery while reducing viral transmission. Benefits became clear during the pandemic as telehealth connected: (a) clinicians to patients while minimizing physical contact and conserving personal protective equipment, and (b) inpatients to family members during restricted visitation. Along with telehealth reimbursement policy changes, these benefits contributed to the rapid use of inpatient telehealth. However, the need to rapidly deploy telehealth programs in the early days of the pandemic hindered many institutions from understanding the full impact of telehealth on inpatient nursing workflows. The purpose of this study was to conduct a rapid human factors qualitative assessment of an inpatient telehealth program on nursing workflows.
Methods: For this study, semi-structured interviews were conducted with seven nurses from a 10-hospital healthcare system to elicit their needs related to telehealth deployment and optimize telehealth technology design. Interview topics included 1) telehealth education and training, 2) the use of telehealth for family visits, remote rounding, and specialist consults; 3) procurement and use of telehealth technology; and 4) nursing satisfaction and interest in the continued use of telehealth. Data was thematically analyzed using affinity diagraming through the Systems Engineering Initiative for Patient Safety (SEIPS) framework.
Results: Three themes emerged. 1) Education and training, 2) Technology, and 3) Workflow. Several sub-themes added clarity to the themes. Education: Participants preferred in-person training and communication about telehealth updates with job aids for troubleshooting. Initial rollout and education, including troubleshooting for technical issues, was an area of concern for clinicians who struggled with technology and relied on others to assist them. Technology: Technology challenges involved dropped calls, sanitizing tablets, and limitations of the number of participants on a call. Workflow: Task and workflow themes included providing telehealth education to patients and their families, scheduling telehealth visits and initiating the call, and telehealth device maintenance and management. The physical tablets and workstations on wheels were devices that needed to be cleaned prior to use by other patients, leading to more tasks to be added to the workflow of telehealth use. The development of a new role focused on managing telehealth use and implementation was successful in aiding an already overwhelmed workload among clinicians. Overall, while the implementation of telehealth was well-received among clinicians for remote patient family visits and discussion of care, there arose changes to workflow that required additional support.