Sustainability in Quality Improvement: Outcomes of a Novel Pediatric Virtual Urgent Care in Ontario, Canada.
5 affiliations
- 1McMaster University, Michael G DeGroote School of Medicine, Hamilton, Ontario, Canada.
- 2Western University, Schulich School of Medicine and Dentistry, Department of Surgery, London, Ontario, Canada.
- 3London Health Sciences Centre, Department of Otolaryngology - Head and Neck Surgery, London, Ontario, Canada.
- 4Child Health Research Institute, London, Ontario, Canada.
- 5Western University, Schulich School of Medicine and Dentistry, Department of Paediatrics, London, Ontario, Canada.
Abstract
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 CO₂ 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 CO₂ 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.
Related
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BibTeX
@article{lim2026sustainability,
title = {{Sustainability in Quality Improvement: Outcomes of a Novel Pediatric Virtual Urgent Care in Ontario, Canada.}},
author = {Emma Lim and Julie Strychowsky and Anna C Gunz and Sheena Belisle},
journal = {The western journal of emergency medicine},
year = {2026},
month = jul,
doi = {10.5811/westjem.54076},
url = {https://europepmc.org/article/MED/42900940},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sustainability in Quality Improvement: Outcomes of a Novel Pediatric Virtual Urgent Care in Ontario, Canada.
AU - Emma Lim
AU - Julie Strychowsky
AU - Anna C Gunz
AU - Sheena Belisle
PY - 2026
DA - 2026/07/28
JO - The western journal of emergency medicine
DO - 10.5811/westjem.54076
UR - https://europepmc.org/article/MED/42900940
AB - 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 CO₂ 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 CO₂ 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.
SN - 1936-900X
SN - 1936-9018
ER -