Date of Award

Winter 11-29-2023

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Dr. Mary Brann

Second Advisor

Dr. Beverly Bokovitz


Practice Problem: The lack of resources such as transportation, insurance, and finances can negatively impact a patient’s access to much-needed specialty care. Providing education, assessing telehealth literacy, and creating a specific process for identifying appropriate telehealth visits can improve pediatric specialty access to care.

PICOT: The PICOT question for this project was: In pediatric orthopedic clinic patients (P), what is the impact of the active introduction of telehealth as a clinic visit option (I) versus the current standard passive process of scheduling telehealth visits (C) on the rates of access to care (O) after nine total weeks of process implementation (T) in the clinic scheduling process.

Evidence: Adherence to patient care plans and improved access to care have been shown to be positively impacted by the utilization of telehealth services. Showing patients the benefits of telehealth and assessing the appropriate use of telehealth in clinical settings can support ongoing access to continued care.

Intervention: Creating a specific, prescriptive approach to utilizing telehealth with the appropriate participant populations by setting specific criteria for use and assessing telehealth literacy and education when necessary to increase telehealth visits.

Outcome: Patients who met the criteria for appropriateness of telehealth use and participated in all interventions showed a higher correlation to consenting to future telehealth utilization as indicated by scheduled telehealth appointments.

Conclusion: This evidence-based project utilized Lewin’s change theory and the Johns Hopkins Evidence-Based model as a framework to support increased access to clinical care for pediatric patients by utilizing a prescriptive approach to meeting visit criteria and improving telehealth literacy through education to consent to telehealth utilization.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

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