{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T02:09:54Z","timestamp":1769825394762,"version":"3.49.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the impact of nurse-led visits on in-person referrals for clinical evaluation from pediatric urgent care telehealth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted this quality improvement study within our 3 freestanding in-person pediatric urgent care clinics and telehealth service. In May 2022, we implemented nurse-led visits to offer diagnostic and therapeutic interventions including rapid group A streptococcal testing, urinalysis, respiratory viral testing, and intramuscular antibiotic injections without requiring an additional clinical evaluation following a telehealth encounter. We measured the percentage of telehealth encounters with in-person referrals as the primary outcome. We tracked the percentage of encounters with nurse-led visits and return visits within 72 hours as process and balancing measures, respectively. We used control charts to identify special cause variation over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In-person referrals following telehealth visits decreased from 23.0% to 12.3% after implementing nurse-led visits. The use of nurse-led visits increased over time from 4.0% to 6.8%. Rapid group A streptococcal testing accounted for most nurse-led visits (64.0%). Only 2.8% of nurse-led visits resulted in return visits within 72 hours. Nurse-led visits were associated with shorter length of stays (32 min) compared with in-person clinical evaluations (69 min) and had an average cost-savings of $135 compared with visits of similar medical complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Integrating nurse-led visits into urgent care telehealth encounters provides a safe and effective option for diagnostic and therapeutic interventions in the virtual setting. The results support the use of nurse-led visits to expand access to high-quality acute care, reduce unnecessary referrals, and promote evidence-based practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pec.0000000000003501","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T06:00:38Z","timestamp":1762149638000},"page":"114-120","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Nurse-Led Visits Reduce In-Person Referral From Urgent Care Telehealth"],"prefix":"10.1097","volume":"42","author":[{"given":"Amanda","family":"Mason","sequence":"first","affiliation":[{"name":"Division of Urgent Care and Express Care, Children's Mercy Kansas City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Whitt","sequence":"additional","affiliation":[{"name":"Division of Urgent Care and Express Care, Children's Mercy Kansas 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