Semester

Summer

Date of Graduation

2026

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Committee Chair

Kendra Barker

Committee Member

Amy Guido

Committee Member

Chasity Leskosky

Abstract

Abstract

Improving Access to Care and Utilization of Telehealth in Pediatric Inflammatory Bowel Disease Patients Through Scheduling Interventions: A Quality Improvement Project

Sarah Bergstrom

Introduction/Background. Inflammatory bowel disease (IBD) tends to affect pediatric patients with a more severe, aggressive phenotype as compared to adults. Following closely with a pediatric gastroenterologist (GI) is best practice to manage pediatric IBD. However, pediatric subspecialty clinics are generally located within academic institutions in urban areas. Patients in rural areas often have limited access to pediatric GI care, and poor access to care is associated with increased risk of poor disease control. Telehealth subspecialty care is an evolving modern method to address access to care. The project site is a participant in the Improved Care Now (ICN) Network and aims to adhere to their recommended guidelines. One guideline indicates that pediatric IBD patients should be seen at least once every 6 months, or 200 days.

Evidence Review. Current evidence suggests that telehealth increases access to care and improves patient outcomes, with positive patient satisfaction.

Purpose. The purpose of this project was to improve the scheduling process and increase the offering of telehealth visits for pediatric IBD patients receiving care from the pediatric GI department at the project site. The overall goal was to increase access to care and improve patient outcomes over time.

Interventions. Interventions included shifting to internal department scheduling, performing a manual review of the department IBD population to determine patients eligible for telehealth, and facilitating telehealth appointments for these patients to meet ICN benchmarks.

Methods. This quality improvement (QI) project used the Institute for Healthcare Improvement (IHI) Model for Improvement, via Plan-Do-Study-Act (PDSA) cycles. There were three PDSA cycles completed during the project.

Results. Although there are some fluctuations in the data points, there is an overall increase in the number of visits completed that correlates with the increase in visits scheduled within the department. There is strong support for telehealth within the pediatric GI department at the project site, with 47.5% of pediatric IBD patients being seen via telehealth during the 12-week project. There was unfortunately a slight decrease in pediatric patients with IBD having had an appointment within the last 200 days. Despite the slight decline from 87 to 85%, the goal of 85% of patients was still achieved.

Conclusions. Although additional research is needed, there is evidence to show that streamlining scheduling and use of telehealth can significantly increase access to care for the pediatric IBD population served at the project site. Having a variety of individuals scheduling appointments can cause confusion and inconsistency with compliance. These results could be conveyed to other subspecialty departments, as they are likely to face similar scheduling challenges. Access to care will always be a challenge due to a variety of unique barriers.

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