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Leveraging telemedicine to improve the quality of care delivered to pediatric burn patients in a large health system
Patricia A. Morrell, BSN, RN-BC1, Alisa Savetamal, MD, FACS2, Emily Christison-Lagay, MD3, Kimberly Barre, BSN, RN, CCRN-K1, Lucas Butler3, Pina Violano, PhD, MSPH, RN-BC, CCRN, CPS-T1, Michael Caty, MD, M.M.M., FACS, FAAP3, Calvin Norway4, Marc Auerbach, MD, MSCI3. 1Yale-New Haven Children's Hospital, New Haven, CT, USA, 2Connecticut Burn Center, Bridgeport, CT, USA, 3Yale University School of Medicine, New Haven, CT, USA, 4Yale-New Haven Hospital, New Haven, CT, USA.

Background: Timely and accurate assessment and management of burn injuries is vital to providing optimal care. Total body surface area and burn depth are commonly determined by visual inspection. Our objective was to evaluate the effects of implementing the use of telemedicine on the disposition and ED dwell time of pediatric burn patients.

Methods: The clinical guideline for the care of a child with burn injury was updated to include the use of hospital devices for photographing burn injuries and uploading media files into the EMR for real time consultation from our health system's Burn Center (HSBC). Our Level I pediatric trauma center registry was queried for all children with burn injuries from January 2009 to March 2016 to assess disposition and ED dwell time.

Results: A total of 95 patients were identified of which 52 were transferred to the HSBC and 19 were transferred outside of our system. Of these 52 transfers, the average per year prior to telemedicine implementation was 4.2 patients. The yearly average number of transfers that occurred after implementation was 14.5 patients. ED dwell time prior to transfer decreased from 4:23(hr:min) before to 2:55 after telemedicine.

Conclusions: The use of telemedicine has positive impacts on the care of children with burn injuries. It has increased the number of patients appropriately transferred to the HSBC and decreased the ED dwell time prior to transfer.

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