Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative
Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative
Background The COVID-19 outbreak has placed the National Health Service under significant strain. Social distancing measures were introduced in the UK in March 2020 and virtual consultations (via telephone or video call) were identified as a potential alternative to face-to-face consultations at this time.
Local problem The Royal National Orthopaedic Hospital (RNOH) sees on average 11 200 face-to-face consultations a month. On average 7% of these are delivered virtually via telephone. In response to the COVID-19 crisis, the RNOH set a target of reducing face-to-face consultations to 20% of all outpatient attendances. This report outlines a quality improvement initiative to rapidly implement virtual consultations at the RNOH.
Methods The COVID-19 Action Team, a multidisciplinary group of healthcare professionals, was assembled to support the implementation of virtual clinics. The Institute for Healthcare Improvement approach to quality improvement was followed using the Plan-Do-Study-Act (PDSA) cycle. A process of enablement, process redesign, delivery support and evaluation were carried out, underpinned by Improvement principles.
Results Following the target of 80% virtual consultations being set, 87% of consultations were delivered virtually during the first 6 weeks. Satisfaction scores were high for virtual consultations (90/100 for patients and 78/100 for clinicians); however, outside of the COVID-19 pandemic, video consultations would be preferred less than 50% of the time. Information to support the future redesign of outpatient services was collected.
Conclusions This report demonstrates that virtual consultations can be rapidly implemented in response to COVID-19 and that they are largely acceptable. Further initiatives are required to support clinically appropriate and acceptable virtual consultations beyond COVID-19.
Registration This project was submitted to the RNOH’s Project Evaluation Panel and was classified as a service evaluation on 12 March 2020 (ref: SE20.09).
PDSA, quality improvement, telemedicine
1-8
Gilbert, Anthony William
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Billany, Joe C.T.
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Adam, Ruth
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Martin, Luke
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Tobin, Rebecca
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Bagdai, Shiv
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Galvin, Noreen
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Farr, Ian
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Allain, Adam
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Davies, Lucy
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Bateson, John
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1 June 2020
Gilbert, Anthony William
a450c811-c6d3-4853-ae35-9f5287db8efa
Billany, Joe C.T.
8b9dd187-5846-4fbb-90f5-8cd3ee965571
Adam, Ruth
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Martin, Luke
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Tobin, Rebecca
9114fff8-70ee-4e29-8e03-ad6496902fcd
Bagdai, Shiv
a3435a7e-9c6e-40f3-bcbc-8c1999f66bb5
Galvin, Noreen
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Farr, Ian
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Allain, Adam
ddcadd8e-f48c-4c94-b9df-b03186976a92
Davies, Lucy
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Bateson, John
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Gilbert, Anthony William, Billany, Joe C.T., Adam, Ruth, Martin, Luke, Tobin, Rebecca, Bagdai, Shiv, Galvin, Noreen, Farr, Ian, Allain, Adam, Davies, Lucy and Bateson, John
(2020)
Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative.
BMJ Open Quality, 9 (2), , [e000985].
(doi:10.1136/bmjoq-2020-000985).
Abstract
Background The COVID-19 outbreak has placed the National Health Service under significant strain. Social distancing measures were introduced in the UK in March 2020 and virtual consultations (via telephone or video call) were identified as a potential alternative to face-to-face consultations at this time.
Local problem The Royal National Orthopaedic Hospital (RNOH) sees on average 11 200 face-to-face consultations a month. On average 7% of these are delivered virtually via telephone. In response to the COVID-19 crisis, the RNOH set a target of reducing face-to-face consultations to 20% of all outpatient attendances. This report outlines a quality improvement initiative to rapidly implement virtual consultations at the RNOH.
Methods The COVID-19 Action Team, a multidisciplinary group of healthcare professionals, was assembled to support the implementation of virtual clinics. The Institute for Healthcare Improvement approach to quality improvement was followed using the Plan-Do-Study-Act (PDSA) cycle. A process of enablement, process redesign, delivery support and evaluation were carried out, underpinned by Improvement principles.
Results Following the target of 80% virtual consultations being set, 87% of consultations were delivered virtually during the first 6 weeks. Satisfaction scores were high for virtual consultations (90/100 for patients and 78/100 for clinicians); however, outside of the COVID-19 pandemic, video consultations would be preferred less than 50% of the time. Information to support the future redesign of outpatient services was collected.
Conclusions This report demonstrates that virtual consultations can be rapidly implemented in response to COVID-19 and that they are largely acceptable. Further initiatives are required to support clinically appropriate and acceptable virtual consultations beyond COVID-19.
Registration This project was submitted to the RNOH’s Project Evaluation Panel and was classified as a service evaluation on 12 March 2020 (ref: SE20.09).
Text
Rapid implementation of virtual clinics due to COVID-19 report and early evaluation of a quality improvement initiative
- Accepted Manuscript
Text
e000985.full
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More information
Accepted/In Press date: 13 May 2020
e-pub ahead of print date: 21 May 2020
Published date: 1 June 2020
Additional Information:
Publisher Copyright:
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
Keywords:
PDSA, quality improvement, telemedicine
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Local EPrints ID: 442869
URI: http://eprints.soton.ac.uk/id/eprint/442869
PURE UUID: 772e7fbf-0cb6-4566-bb8c-279d22a3d4ed
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Date deposited: 30 Jul 2020 16:30
Last modified: 16 Mar 2024 08:50
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Contributors
Author:
Anthony William Gilbert
Author:
Joe C.T. Billany
Author:
Ruth Adam
Author:
Luke Martin
Author:
Rebecca Tobin
Author:
Shiv Bagdai
Author:
Noreen Galvin
Author:
Ian Farr
Author:
Adam Allain
Author:
Lucy Davies
Author:
John Bateson
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