Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Carolyn Sipes

Abstract

Telehealth (TH) is one of the newest avenues for improving accessibility and healthcare accommodations for patients with chronic health issues and terminal illness. The purpose of a quality improvement (QI) initiative at the project site was to align current evidence-based practice to address the disparities in the admissions process experienced by patients seeking hospice care from remote locations. The health belief model and Roger's diffusion of innovation theory were used to inform this doctor of nursing QI evaluation project to determine whether using a standardized evidence-based intake assessment process delivered by TH would increase accessibility for patients seeking hospice services. Data provided by the hospice site on the number of admissions to hospice 3 months prior to and 3 months post TH initiative were analyzed. Findings revealed that the number of admissions to hospice increased approximately 30% after the implementation of the TH initiative. A finding of a 29% increase in patients living more than 20 miles away from the main hospice campus supports improvement in access for rural patients. It is recommended that the TH be used in all hospice admissions, especially given the current health care climate. TH has potential to make a difference in a patient's eligibility and accessibility to hospice services during the admission phase of receiving palliative care. Telehealth using a standardized overall admission assessment process, has the potential of promoting a positive social change in the admittance of patients seeking hospice services with improved and more timely access to care.

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