{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T19:57:11Z","timestamp":1790539031438,"version":"4.1.0"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"5","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Western Journal of Emergency Medicine"],"abstract":"<p>Introduction: Virtual care is expected to play an increasingly important role in the Canadian healthcare system, with the 2023-2024 Health Canada Departmental Plan outlining the advancement of digital health solutions as a focal point. However, key outcomes of transitioning from traditional in-person healthcare appointments to a virtual model of care are not yet well-described. Here, we apply the Sustainability in Quality Improvement (SusQI) framework to patients seen in a novel pediatric virtual urgent care (VUC) program to quantify the environmental, economic, and social impacts of virtual care. Methods: We conducted a retrospective analysis of provincial pediatric VUC visits staffed by pediatric emergency physicians and nurse practitioners during the 2020-2025 fiscal years. We focused on three key metrics: (1) economic value, measured as travel costs avoided; (2) environmental value, measured in fuel saved (L) and carbon emissions reduced (kg CO\u2082 eq); and (3) social value, assessed using Ontario Marginalization (ON-Marg) Index quintiles. Results: A total of 12,900 virtual visits were completed during the study period, 99.9% via the Webex platform. Net savings totaled $998,100. Environmental benefits included 128,700 L of fuel saved and 384,200 kg CO\u2082 eq emissions avoided. Summary ON-Marg Index scores were similar between groups (2.87 for in-person emergency department (ED) visits; 2.91 for virtual visits). Data collected between July 2023-April 2025 show that 10.6% (353) of visits resulted in subsequent in-person ED presentation. Conclusion: Virtual urgent care resulted in significant financial and environmental savings per visit. These benefits included reduced financial and time burdens for families, lower hospital-related expenditures, improved environmental performance, and diversion of low-acuity cases from the ED. Comparable ON-Marg scores between patients seen virtually and in-person suggest accessibility across socioeconomic groups. These findings indicate that pediatric VUC is a viable complement to traditional care, providing meaningful cost and environmental savings while ensuring equitable access.<\/p>","DOI":"10.5811\/westjem.54076","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:47:56Z","timestamp":1785304076000},"source":"Crossref","is-referenced-by-count":0,"title":["Sustainability in Quality Improvement: Outcomes of a Novel Pediatric Virtual Urgent Care in Ontario, Canada"],"prefix":"10.5811","volume":"27","author":[{"given":"Emma","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Strychowsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C","family":"Gunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena","family":"Belisle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2026,7,29]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt9316241d\/qt9316241d.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T19:28:43Z","timestamp":1790537323000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/9316241d"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":0,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9,24]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.54076","relation":{},"ISSN":["1936-9018"],"issn-type":[{"value":"1936-9018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]}}}