Understanding the benefits and challenges of outpatient virtual care during the COVID-19 pandemic in a Canadian pediatric rehabilitation hospital

Abstract

Purpose

The evolving virtual health care experience highlights the potential of technology to serve as a way to enhance care. Having virtual options for assessment, consultation and intervention were essential during the coronavirus (COVID-19) pandemic, especially for children with disabilities and their families. The purpose of our study was to describe the benefits and challenges of outpatient virtual care during the pandemic within pediatric rehabilitation.

Methods

This qualitative study, part of a larger mixed methods project, involved in-depth interviews with 17 participants (10 parents, 2 youth, 5 clinicians) from a Canadian pediatric rehabilitation hospital. We analyzed the data using a thematic approach.

Results

Our findings demonstrated three main themes: (1) benefits of virtual care (e.g., continuity of care, convenience, stress reduction and flexibility, and comfort within the home environment and enhanced rapport); (2) challenges related to virtual care (e.g., technical difficulties and lack of technology, environmental distractions and constraints, communication difficulty, and health impacts); and (3) advice for the future of virtual care (i.e., offering choice to families, enhanced communication and addressing health equity issues).

Conclusions

Clinicians and hospital leaders should consider addressing the modifiable barriers in accessing and delivering virtual care to optimize its effectiveness.

IMPLICATIONS FOR REHABILITATION

• Families are invested in access to virtual care appointments and can benefit from clear communication about choices regarding appointment options and supports in how to access and use technology for equitable access to care.

• Hospitals should aim to provide clinicians with an appropriate workspace (i.e., private, quiet with adequate room to demonstrate what they need to do), equipment and technology to have virtual care appointments.

• Current understanding of virtual care delivery suggests a tailored approach, with some types of appointments, such as follow-ups or check-ins, more suited to this modality than other more hands-on therapy.

Keywords:

• COVID-19 pandemic
• pediatric
• qualitative
• virtual care

Acknowledgments

We wish to acknowledge this land on which the University of Toronto operates. For thousands of years, it has been the traditional land of the Huron-Wendat, the Seneca, and the Mississaugas of the Credit. Today, this place is still the home to many Indigenous people from across Turtle Island and we are grateful to have the opportunity to work on this land. We also thank the participants who shared their experiences and the staff and volunteers in the TRAIL and SPARK labs.

Author contributions

FVW & SL wrote the protocol for this study. SL drafted the manuscript. SL & SR reviewed all transcripts and analyzed the data; FVW reviewed the transcripts and NVivo codes; CZ conducted the majority of the interviews. All authors reviewed and had an opportunity to comment on the final version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded through a Center for Leadership grant from the Holland Bloorview Foundation, awarded to F. Virginia Wright and Sally Lindsay.