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.
COVID-19, Normalisation Process Theory, clinician preferences, organisation preferences, patient preferences, virtual consultations
775-790
Gilbert, Anthony W.
a450c811-c6d3-4853-ae35-9f5287db8efa
Jones, Jeremy
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Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
May, Carl R.
8d999430-9cba-4e4a-8c29-af8b7c074f0f
April 2022
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), .
(doi:10.1111/hex.13425).
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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Patient, clinician and manager experience ...
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Health Expectations - 2022 - Gilbert - Patient clinician and manager experience of the accelerated implementation of
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Accepted/In Press date: 21 December 2021
e-pub ahead of print date: 10 January 2022
Published date: April 2022
Additional Information:
Funding Information:
The authors thank members of the CONNECT Project Patient and Public Involvement steering group for their invaluable contributions to the overall study design of the CONNECT Project and obtaining funding for the PhD Fellowship. The authors also thank John Doyle, Rachel Dalton, Anju Jaggi, Iva Hauptmannova and colleagues within the Therapies Directorate and Research and Innovation Centre at the Royal National Orthopaedic Hospital for their ongoing support. The authors are grateful to the 20 patients and 35 members of staff who participated in this study. Anthony W. Gilbert is funded by a National Institute for Health Research (NIHR), Clinical Doctoral Research Fellowship for this study project (ICA-CDRF-2017-03-025). Anthony W. Gilbert and Carl R. May are supported by the National Institute for Health Research ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Funding Information:
The authors thank members of the CONNECT Project Patient and Public Involvement steering group for their invaluable contributions to the overall study design of the CONNECT Project and obtaining funding for the PhD Fellowship. The authors also thank John Doyle, Rachel Dalton, Anju Jaggi, Iva Hauptmannova and colleagues within the Therapies Directorate and Research and Innovation Centre at the Royal National Orthopaedic Hospital for their ongoing support. The authors are grateful to the 20 patients and 35 members of staff who participated in this study. Anthony W. Gilbert is funded by a National Institute for Health Research (NIHR), Clinical Doctoral Research Fellowship for this study project (ICA‐CDRF‐2017‐03‐025). Anthony W. Gilbert and Carl R. May are supported by the National Institute for Health Research ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Publisher Copyright:
© 2022 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Keywords:
COVID-19, Normalisation Process Theory, clinician preferences, organisation preferences, patient preferences, virtual consultations
Identifiers
Local EPrints ID: 454356
URI: http://eprints.soton.ac.uk/id/eprint/454356
ISSN: 1369-6513
PURE UUID: 687c7d33-8641-4c14-aba9-5f3d63fbbf14
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Date deposited: 08 Feb 2022 17:33
Last modified: 17 Mar 2024 02:56
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Author:
Anthony W. Gilbert
Author:
Carl R. May
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