scholarly journals Role for structured telephone clinics in paediatric gastroenterology: reflections, lessons and patient feedback

2019 ◽  
Vol 6 (1) ◽  
pp. e000245 ◽  
Author(s):  
Hazel Duncan ◽  
Richard K Russell

BackgroundTelephone clinics have been established within our department to try and improve communication with families, limit waiting times and help face-to-face clinics run more efficiently. As part of the ongoing care needs for our patients and families it was felt important to determine if telephone clinics were meeting the needs of the young person and family as well as those of the health professional.ObjectiveTo assess the effects of a structured consultant delivered telephone clinic.MethodData were collected regarding patients who had a consultant telephone appointment between July 2016 and March 2017. Data collected include demographics and appointment reason. An evaluation questionnaire was sent to all parent/carer(s).Results25 clinics comprising 194 contacts, including 34 duplicate contacts. 120 questionnaires sent. 7/160 (4.3%) were new patients. The main contact reason was biopsy results after endoscopy (93/180; 52%). Failure to attend rate was significantly lower at 18/194 (9.2%) compared with failure to attend rate of 52/240 (21.6%) for a traditional clinic (p<0.001). 40/120 (33%) returned completed questionnaires, 25/40 (68.4%) reported the reason for appointment was test results. Travel time and school attendance were identified as main advantages. Mean parental rating score for the service was 8/10 with 21/40 (54%) scoring the service as 10/10.ConclusionThe initial results of this audit are promising. Structured telephone appointments have a key role in delivering patient care in paediatric gastroenterology and have benefits to health professional, parent/carer and patients. These clinics have now been widely adopted by all members of our department.

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696773
Author(s):  
Abi Eccles ◽  
Mike Hopper ◽  
Helen Atherton

BackgroundOnline triage software is a new way to triage patients online that allows patients to describe their problem via an online form. A GP then contacts the patient to arrange either a face-to-face or telephone consultation.AimThis study aimed to explore use of online consultation software and gain insight into patients’ experiences of using online consultations, identifying potential barriers and facilitators to use.MethodThis is a mixed methods retrospective study analysing data about patient users and their associated feedback. Data from a sample of 5591 patients were quantitatively analysed to describe characteristics of users. 576 out of the 5591 users left free-text feedback comments on their experience of use. These were thematically analysed.ResultsThe highest levels of use were observed in 25–35-year olds and lowest from those aged >65. Key themes identified included convenience, consultation quality, appropriateness, resource-use and functionality. Within each, a range of subthemes were present representing both positive and negative perceptions, suggesting that experiences of using online triage varied and were often context-dependentConclusionThere are various advantages to online triage software, but these are context-dependent. Therefore, such applications should be offered as an additional way to contact the GP surgery, rather than a replacement for more established methods, to ensure appropriate and equal access for patients.


Author(s):  
Tom Jansen ◽  
Martin Gathen ◽  
Amadeo Touet ◽  
Hans Goost ◽  
Dieter Christian Wirtz ◽  
...  

Abstract Introduction During the current COVID-19 pandemic video consultations are increasingly common in order to minimize the risk of infection for staff and patients. The aim of this study was to evaluate the feasibility of a spine examination via video. Methods A total of 43 patients were recruited. Each participant underwent a video-based (VB) and a conventional face-to-face (FTF) spine examination. Pain intensity, active range of motion, inspection, a neurophysiologic basic exam and provocations tests were evaluated using video-based and face-to-face methods. Results The intra-rater reliability (IRR) was measured between both examinations. Good to very good IRR values were obtained in inspection (Kappa between 0,752 und 0,944), active range of motion and basic neurophysiological examination (Kappa between 0,659 und 0,969). Only moderate matches were found in specific provocation tests (Kappa between 0,407 und 0,938). A video-based spine examination is a reliable tool for measuring pain intensity, active range of motion and a basic neurophysiologic exam. Conclusion A basic spine examination during a video consultation is possible. A good agreement of the test results between video-based and face-to-face examination could be found.


2021 ◽  
Author(s):  
Madison Milne-Ives ◽  
John Leyden ◽  
Inocencio Maramba ◽  
Ray Jones ◽  
Arunangsu Chatterjee ◽  
...  

BACKGROUND The NHS cannot keep up with the demand for operations and procedures. Preoperative assessments, which can last 30 minutes to 2 hours, could be conducted online to save patient and clinician time, reducing wait times for operations. MyPreOp is a cloud-based platform where patients can set up an account and complete their preoperative questionnaires. This data is reviewed by a nurse, who determines if they need a subsequent face-to-face appointment. OBJECTIVE The primary objective was to describe the potential impact of MyPreOp® (Ultramed Ltd, Penryn, UK) the number of face-to-face appointments. Secondary objectives were to examine the time spent on preoperative assessments completed using MyPreOp in everyday use in NHS Trusts and user ratings of usability and acceptability. METHODS A case study service evaluation of data collected by the MyPreOp system from two NHS Trusts (Guy’s and St Thomas’ and Royal United Hospitals Bath) and the private BMI Bath Clinic during the four-month period of September to December 2020. MyPreOp is delivered by the hospital conducting the preoperative assessment but is typically completed at home at the patients’ convenience. Participants were adults of any age and health status at the participating hospitals who used MyPreOp to complete a preoperative assessment before a scheduled surgery. The primary outcome was the number of face-to-face appointments avoided by patients who used MyPreOp. Secondary outcomes were the length of time spent by nurses completing preoperative assessments, associated travel-related CO2 emissions, and quantitative user feedback. RESULTS Data from 2,500 participants was included. Half of the patients assessed did not need a further face-to-face appointment and required a median of only 5.3 minutes of nurses’ time. The reduction in appointments was associated with a small saving of CO2e emissions (9.05 tonnes). Patient feedback was generally positive: 80% of respondents rated MyPreOp as easy or very easy to use and 85% thought the overall experience was good or very good. CONCLUSIONS This evaluation demonstrated potential benefits of MyPreOp. However, further research using rigorous scientific methodology and a larger sample of NHS Trusts and users is needed to provide strong evidence of MyPreOp’s efficacy, usability, and cost-effectiveness.


2020 ◽  
Vol 15 (3) ◽  
pp. 282-292
Author(s):  
Wibeche Ingskog ◽  
Wenche S. Bjorbækmo

This paper presents findings from a study on the ways in which counsellors working at national centres for rare disorders in Norway experience preparing, and being prepared for, a face-to-face patient consultation. The research involved semi-structured interviews with five experienced counsellors from different health professional backgrounds working at two separate centres. These interviews were then analysed with reference to the theoretical insights of phenomenologists. The excerpts chosen for this paper shed particular light on the process of preparing for a face-to-face patient consultation. Our findings underline the significance of preparing and being prepared while also drawing attention to the multifaceted, complex and ambiguous nature of the processes involved. Preparing for face-to-face consultations with patients is revealed to require approaches that are thoughtful, flexible and empathic. To be prepared for something one does not yet know is about being open to the unexpected and the unpredictable.


2020 ◽  
pp. 117-126
Author(s):  
Cassie Hudson ◽  
Audon Archibald ◽  
Tania Heap

Online educators rely on asynchronous discussions to satisfy the bulk of student-student engagement that is lost when transferring from a face-to-face to an online format. However, not all discussion platforms are created equal and some specialized tools may offer advantages over standard tools embedded in more comprehensive learning management systems (LMS). In this study, we compare two online discussion platforms – one is the native discussion tool embedded within the Canvas LMS and the other is a specialized discussion platform, Packback, which supports students and instructors with gamified elements and artificial intelligence. Specifically, we assess whether post quality differs across these platforms, as measured by average word count, cited sources and weekly participation rate. The initial results are mixed and differ by course, leading us to conclude that the impact of platform on engagement and quality likely depends on the course content, instructor and protocol.


2022 ◽  
pp. 256-272
Author(s):  
Patrícia Rodrigues ◽  
Manuela Soares Rodrigues ◽  
Diana Pinheiro ◽  
Cecília Nunes

Health influences general well-being, and well-being affects future health. Oral health professionals report a decreased well-being and a higher burnout. This chapter measures and evaluates the perception of the health professional and the patient about factors of stress and well-being. It evaluates the strategies used to overcome the anxiety and stress that involve the meeting. Two surveys applied by questionnaire, with face-to-face and online dissemination, the first to patients and second to dentists, were done. Of the 245 patients, 46% consider themselves to be anxious. The instruments used in a clinical environment cause discomfort, and their noise is the predominant cause for this fear. Of the 306 dentists, 80% show the ability to face difficult situations. Finally, 90% have an awareness that contributes to the well-being of others. Oral health professionals should prepare themselves with techniques to develop a therapeutic relationship that is more positive, calm, and less stressful.


Author(s):  
Henglien Lisa Chen

To address the risks to families of the availability of care for their older family members, this paper explores the impact of different care systems on the way that relevant care actors contribute to the long-term care of older people. It is based on an empirical study of the care needs assessment and care provision in England, the Netherlands and Taiwan. The participants in the study include 143 care actors at national, regional and local levels across the countries. It found that the objective of providing care needs is similar in each of the countries studied. However, the everyday life of professionals and in/formal carers differs based on the care culture and care policy in each country. Overall, care professionals and formal carers experience satisfaction in their caring role when sufficient time is available for them to work with individuals. Face-to-face contact with older people is important to care professionals if adequate needs assessment could be performed. Helping informal carers extend their ability to carry out their role may improve their well-being as carers and reduce the demand for formal care services.


2007 ◽  
Vol 15 (5) ◽  
pp. 914-921 ◽  
Author(s):  
Miriam Aparecida Barbosa Merighi ◽  
Renata Tavares Franco Rodrigues ◽  
Selisvane Ribeiro da Fonseca Domingos

This study aimed to understand the meanings women who possess health plans hold regarding pregnancy and get to know their care needs in this phase of the vital cycle. It was based on the qualitative research of phenomenological inspiration. The discourses analysis was based on the sociologist and fenomenologist Alfred Schutz's thought. Having health plans and being attended in private institutions were defined as inclusion criteria. The following categories emerged from the discourses: having new responsibilities; experiencing a special situation; experiencing insecurity, anxiety and expectations; feeling limited; trusting the health professional. It was found, through the analysis of categories, that the experience of the pregnant women who participated in the study is similar to those who do not possess health plans. However, in the category "trusting the health professional" it was possible to perceive the importance of possessing health plan, which allows the intersubjectivity between the woman and the health professional.


2020 ◽  
Vol 33 (6) ◽  
pp. e492-e504
Author(s):  
Wendy Brodribb ◽  
Glenda Hawley ◽  
Ben Mitchell ◽  
Ann Mathews ◽  
Irena Zakarija-Grković

2016 ◽  
Vol 22 (8) ◽  
pp. 504-512 ◽  
Author(s):  
Liam J Caffery ◽  
Mutaz Farjian ◽  
Anthony C Smith

We undertook a scoping review of the published literature to identify and summarise key findings on the telehealth interventions that influence waiting times or waiting lists for specialist outpatient services. Searches were conducted to identify relevant articles. Articles were included if the telehealth intervention restructured or made the referral process more efficient. We excluded studies that simply increased capacity. Two categories of interventions were identified – electronic consultations and image-based triage. Electronic consultations are asynchronous, text-based provider-to-provider consultations. Electronic consultations have been reported to obviate the need for face-to-face appointments between the patient and the specialist in between 34–92% of cases. However, it is often reported that electronic consultations are appropriate in less than 10% of referrals for outpatient care. Image-based triage has been used successfully to reduce unnecessary or inappropriate referrals and was used most often in dermatology, ophthalmology and otolaryngology (ENT). Reported reduction rates for face-to-face appointments by specialty were: dermatology 38–88%, ophthalmology 16–48% and ENT 89%. Image–based triage can be twice as effective as non-image based triage in reducing unnecessary appointments. Telehealth interventions can effectively be used to reduce waiting lists and improve the coordination of specialist services, and should be considered in conjunction with clinical requirements.


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