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Patient, clinician and manager experience of the accelerated implementation of virtual consultations following COVID‐19: a qualitative study of preferences in a tertiary orthopaedic rehabilitation setting

Patient, clinician and manager experience of the accelerated implementation of virtual consultations following COVID‐19: a qualitative study of preferences in a tertiary orthopaedic rehabilitation setting
Patient, clinician and manager experience of the accelerated implementation of virtual consultations following COVID‐19: a qualitative study of preferences in a tertiary orthopaedic rehabilitation setting
Aim: to investigate the experiences of patients, clinicians and managers during the accelerated implementation of virtual consultations (VCs) due to COVID-19. To understand how patient preferences are constructed and organized.

Methods: semi-structured interviews with patients, clinicians and managerial staff at a single specialist orthopaedic centre in the United Kingdom. The interview schedule and coding frame were based on Normalisation Process Theory. Interviews were conducted over the telephone or by video call. Abductive analysis of interview transcripts extended knowledge from previous research to identify, characterize and explain how patient preferences for VC were formed and arranged.

Results: fifty-five participants were included (20 patients, 20 clinicians, 15 managers). Key mechanisms that contribute to the formation of patient preferences were identified. These were: (a) context for the consultation (normative expectations, relational expectations, congruence and potential); (b) the available alternatives and the implementation process (coherence, cognitive participation, collective action and reflexive monitoring). Patient preferences are mediated by the clinician and organisational preferences through the influence of the consultation context, available alternatives and the implementation process.

Conclusions: this study reports the cumulative analysis of five empirical studies investigating patient preferences for VC before and during the COVID-19 pandemic as VC transitioned from an experimental clinic to a compulsory form of service delivery. This study has identified mechanisms that explain how preferences for VC come about and how these relate to organisational and clinician preferences. Since clinical pathways are shaped by interactions between patient, clinicians and organisational preferences, future service design must strike a balance between patient preferences and the preferences of clinicians and organisations.

Patient and Public Contribution: the CONNECT Project Patient and Public Involvement (PPI) group provided guidance on the conduct and design of the research. This took place with remote meetings between the lead researcher and the chair of the PPI group during March and April 2020. Patient information documentation and the interview schedule were developed with the PPI group to ensure that these were accessible.
1369-6513
775-790
Gilbert, Anthony W.
a450c811-c6d3-4853-ae35-9f5287db8efa
Jones, Jeremy
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Stokes, Maria
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May, Carl R.
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Gilbert, Anthony W.
a450c811-c6d3-4853-ae35-9f5287db8efa
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
May, Carl R.
8d999430-9cba-4e4a-8c29-af8b7c074f0f

Gilbert, Anthony W., Jones, Jeremy, Stokes, Maria and May, Carl R. (2022) Patient, clinician and manager experience of the accelerated implementation of virtual consultations following COVID‐19: a qualitative study of preferences in a tertiary orthopaedic rehabilitation setting. Health Expectations, 25 (2), 775-790. (doi:10.1111/hex.13425).

Record type: Article

Abstract

Aim: to investigate the experiences of patients, clinicians and managers during the accelerated implementation of virtual consultations (VCs) due to COVID-19. To understand how patient preferences are constructed and organized.

Methods: semi-structured interviews with patients, clinicians and managerial staff at a single specialist orthopaedic centre in the United Kingdom. The interview schedule and coding frame were based on Normalisation Process Theory. Interviews were conducted over the telephone or by video call. Abductive analysis of interview transcripts extended knowledge from previous research to identify, characterize and explain how patient preferences for VC were formed and arranged.

Results: fifty-five participants were included (20 patients, 20 clinicians, 15 managers). Key mechanisms that contribute to the formation of patient preferences were identified. These were: (a) context for the consultation (normative expectations, relational expectations, congruence and potential); (b) the available alternatives and the implementation process (coherence, cognitive participation, collective action and reflexive monitoring). Patient preferences are mediated by the clinician and organisational preferences through the influence of the consultation context, available alternatives and the implementation process.

Conclusions: this study reports the cumulative analysis of five empirical studies investigating patient preferences for VC before and during the COVID-19 pandemic as VC transitioned from an experimental clinic to a compulsory form of service delivery. This study has identified mechanisms that explain how preferences for VC come about and how these relate to organisational and clinician preferences. Since clinical pathways are shaped by interactions between patient, clinicians and organisational preferences, future service design must strike a balance between patient preferences and the preferences of clinicians and organisations.

Patient and Public Contribution: the CONNECT Project Patient and Public Involvement (PPI) group provided guidance on the conduct and design of the research. This took place with remote meetings between the lead researcher and the chair of the PPI group during March and April 2020. Patient information documentation and the interview schedule were developed with the PPI group to ensure that these were accessible.

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More information

Accepted/In Press date: 21 December 2021
e-pub ahead of print date: 10 January 2022

Identifiers

Local EPrints ID: 454356
URI: http://eprints.soton.ac.uk/id/eprint/454356
ISSN: 1369-6513
PURE UUID: 687c7d33-8641-4c14-aba9-5f3d63fbbf14
ORCID for Maria Stokes: ORCID iD orcid.org/0000-0002-4204-0890

Catalogue record

Date deposited: 08 Feb 2022 17:33
Last modified: 23 Jul 2022 01:50

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Contributors

Author: Anthony W. Gilbert
Author: Jeremy Jones
Author: Maria Stokes ORCID iD
Author: Carl R. May

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