Pediatric Therapists Telehealth Experiences

ABSTRACT

Background and Objective(s) Throughout the COVID-19 pandemic, Outpatient Physical, Occupational and Speech therapies at a large urban pediatric hospital averaged 300 to 500 appointments a week. Many appointments were via telehealth;a shift in practice model as most therapy appointments were on-site prior to the pandemic. To ensure quality of care and adapt telehealth to maximize patient/caregiver satisfaction, a quality improvement project was performed, seeking staff feedback regarding telehealth experiences to assist in modifying service delivery models. Study Design: Cross-sectional study. Study Participants & Setting: 47 of 57 therapists (36.17% PT, 25.53% OT, 38.30% SLP) responded to the survey during September 2021. Therapists completed the survey once during a 30-day time period if they provided services via telehealth. Therapists had a range of experiences providing pediatric therapy services (21.28% with 0-3 years to 25.53% with 19+ years). Patients served ranged 2 months to 74 years with diagnoses including autism and cerebral palsy. Materials/Methods: Survey responses are summarized descriptively with the most frequent responses reported using percentages. The electronic survey in Qualtrics consisted of 40 questions with multiple response options including multiple choice, free text, and rank order. The question topics included telehealth training, contributors to success and/ or lack of success (including patient engagement, defined as behavior, motivation, ability to follow directions/structure;and caregiver engagement defined as motivation, capacity to perform therapy, ability to understand instructions from therapist), home exercise program compliance, and plan of care modifications. Result(s) 580 telehealth visits occurred during the survey time. 83.78% of therapists reported patient or caregiver engagement as the biggest contributor to a successful telehealth session and 57.89% reported the same as biggest limiting factor. There was no staff consensus on a certain patient age or diagnosis having the most or least success with telehealth. 47.50% of respondents reported the ability to see the patient in their natural environment as what they liked most about telehealth. 69.23% of therapists reported the inability to use hands on skills with the patient as what they liked least about telehealth. 92.5% of therapists reported their preferred mode of service delivery in the future would be a hybrid model of in-person and telehealth. Conclusions/Significance: Parent and patient engagement were identified as having the most impact on success or nonsuccess of a telehealth session. Providers noted telehealth pros like seeing the patient in their natural environment, and cons like not using hands on skills during treatment. We postulate that the future of pediatric rehab will be a hybrid model of care utilizing both hands on skills during onsite visits and telehealth intervention in the patient's natural environment to extend caregiver involvement and functionality of home programs to improve the lives of the diverse patient population we serve.