ABSTRACT
During the first year of the COVID-19 pandemic, a group of academic geographers got together across borders to share our varied experiences. In this paper we illustrate how this storying of pandemia helped us critically and collaboratively understand, (re)imagine and reconfigure ways of living during a global pandemic. We were especially interested in exploring different forms and practices of collective thinking and academic labour, within and beyond the academy. This paper foregrounds emotions and lived experiences, power and positionality, natures, bodies, and relations, and how they have come to our attention in new, different, or more pronounced ways, through everyday geographies of pandemia. Our aim is to emphasise two important aspects: that pandemia is a state of being with/as/through pandemic, and, as a collective noun, pandemia centres plurality, focusing on the potential to attend to the ways experiences of pandemic are redolent with multiple, overlapping exclusions and belongings, openings and closures. © 2023 American Association of Geographers.
ABSTRACT
Purpose/Objectives: Our pediatric pulmonology clinic caters to an underserved community (primarily African-American and non-english speaking Hispanic patients). Barriers such as transportation, poor literacy and language contribute to a baseline median “no-show” rate of 33% (January 2019 to March 2020). During the COVID-19 pandemic families missed or cancelled in-person visits for fear of contracting the virus during visits. Despite improved access via telemedicine families continued to miss scheduled appointments. Our quality improvement project aimed to reduce the median “no-show” rate from 33% to 20% over 6 months through expansion of telemedicine visits and patient technical support. Design/Methods: A team of physicians, front-desk staff and nurses educated families on telemedicine. We identified and addressed barriers to activating patient portal accounts, logging in during visits, and offered telemedicine appointments in lieu of in-person visits. We tracked monthly data. Results: PDSA 1: We educated and enrolled patients on a patient portal with an inbuilt telemedicine module. Portal activation increased from 20% in April 2020 to 85% by December 2020. Simultaneously, we increased the number of telemedicine appointments from a baseline of 0% in February of 2020 to more than 75% by December 2020. PDSA 2: We recognized that patients were experiencing technical and language issues with our patient portal. We began providing real-time troubleshooting when patients could not log-in for telemedicine visits. PDSA 3: Due to the significant time spent during visits troubleshooting with patients, front-desk staff proactively reached out prior to visits to help patients log in. This proactive approach led to a sustained reduction in the no-show rate of 20% and lower. PDSA 4: When patients missed in-person visits, we offered to convert the visit to a telemedicine visit enabling more consistent patient access to healthcare. Conclusion/Discussion: We reduced the overall no-show rate from a baseline of 33% to 18%. Telemedicine offers a great alternative to in-person visits for chronic disease management.