scholarly journals Delivering outpatient virtual clinics during the COVID-19 pandemic: early evaluation of clinicians’ experiences

2022 ◽  
Vol 11 (1) ◽  
pp. e001313
Author(s):  
Venessa Vas ◽  
Shirley North ◽  
Tiago Rua ◽  
Daniella Chilton ◽  
Michaela Cashman ◽  
...  
Keyword(s):  
Level Of Service ◽  
Outpatient Services ◽  
Model Of Care ◽  
Early Evaluation ◽  
Face To Face ◽  
Early Experiences ◽  
Specialist Services ◽  
Back Face ◽  
Outpatient Appointments ◽  
Depth Interviews

BackgroundThe COVID-19 pandemic has put health systems across the world under significant pressure. In March 2020, a national directive was issued by the National Health Service (NHS) England instructing trusts to scale back face-to-face outpatient appointments, and rapidly implement virtual clinics.MethodsA multidisciplinary team of change managers, analysts and clinicians were assembled to evaluate initial implementation of virtual clinics at Guy’s and St Thomas’ NHS Foundation Trust. In-depth interviews were conducted with clinicians who have delivered virtual clinics during the pandemic. An inductive thematic approach was used to analyse clinicians’ early experiences and identify enablers for longer term sustainability.ResultsNinety-five clinicians from specialist services across the trust were interviewed between April and May 2020 to reflect on their experiences of delivering virtual clinics during Wave I COVID-19. Key reflections include the perceived benefits of virtual consultations to patients and clinicians; the limitations of virtual consultations compared with face-to-face consultations; and the key enablers that would optimise and sustain the delivery of virtual pathways longer term.ConclusionsIn response to the pandemic, outpatient services across the trust were rapidly redesigned and virtual clinics implemented. As a result, services have been able to sustain some level of service delivery. However, clinicians have identified challenges in delivering this model of care and highlighted enablers needed to sustaining the delivery of virtual clinics longer term, such as patient access to diagnostic tests and investigations closer to home.

Telehealth interventions for reducing waiting lists and waiting times for specialist outpatient services: A scoping review

2016 ◽  
Vol 22 (8) ◽  
pp. 504-512 ◽  
Author(s):  
Liam J Caffery ◽  
Mutaz Farjian ◽  
Anthony C Smith
Keyword(s):  
Scoping Review ◽  
Outpatient Care ◽  
Waiting Times ◽  
Waiting Lists ◽  
Referral Process ◽  
Outpatient Services ◽  
Face To Face ◽  
Specialist Services ◽  
Telehealth Intervention

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.

scholarly journals Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative

2020 ◽  
Vol 9 (2) ◽  
pp. e000985 ◽  
Author(s):  
Anthony William Gilbert ◽  
Joe C T Billany ◽  
Ruth Adam ◽  
Luke Martin ◽  
Rebecca Tobin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Service Evaluation ◽  
Quality Improvement Initiative ◽  
Outpatient Services ◽  
Process Redesign ◽  
Early Evaluation ◽  
Face To Face ◽  
Action Team ◽  
Healthcare Improvement ◽  
The Uk

BackgroundThe 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 problemThe 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.MethodsThe 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.ResultsFollowing 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.ConclusionsThis 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.RegistrationThis project was submitted to the RNOH’s Project Evaluation Panel and was classified as a service evaluation on 12 March 2020 (ref: SE20.09).

Young Adults’ Contextualization of Environmental and Sustainability Issues: A Critical Issue for Environmental Education Intervention

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Anthony KOLA-OLUSANYA
Keyword(s):  
Young Adults ◽  
Environmental Education ◽  
Lived Experiences ◽  
Critical Issue ◽  
Decision Makers ◽  
Research Approach ◽  
Face To Face ◽  
Research Questions ◽  
Depth Interviews ◽  
Insight Into

As soon as decision makers are expected to make differences towards sustainable future, young adults’ ability to make informed and sound decisions is considered essential towards securing our planet. This study provides an insight into young adults’ knowledge of key environment and sustainability issues. To answer the key research questions, data were obtained using a qualitative phenomenographic research approach and collected through 18 face-to-face in-depth interviews with research participants. The findings of this study suggest that young adults lived experiences that play a huge role in their level of awareness of topical environmental and sustainability issues critical to humanity’s future on earth. 

scholarly journals Towards the Development of Sustainable Tourism in Pakistan: A Study of the Role of Tour Operators

2021 ◽  
Vol 13 (9) ◽  
pp. 4902
Author(s):  
Zia Ullah ◽  
Rana Tahir Naveed ◽  
Atta Ur Rehman ◽  
Naveed Ahmad ◽  
Miklas Scholz ◽  
...  
Keyword(s):  
Sustainable Tourism ◽  
Developed Countries ◽  
Least Developed Countries ◽  
Face To Face ◽  
Phone Calls ◽  
The Government ◽  
Social Environmental ◽  
Sole Criterion ◽  
Depth Interviews

The literature on sustainable tourism is scant, particularly in the least developed countries. Very few studies touch upon the concept and no holistic theoretical or conceptual frameworks around the idea of sustainable tourism have been formulated. This study aims at exploring the role of tour operators in developing sustainable tourism in Pakistan and how the tour operators (TOs) conceive their role in this regard. TOs were reached through phone calls, emails, and virtual sources as face-to-face interviews were not possible due to COVID-19 pandemic and restrictions on travel by the government. In-depth interviews were conducted to gather data. Results suggest that the TOs although realize the importance of social, environmental, and economic dimensions of tourism on the communities but have no management systems in place to cater accordingly. There are no incentives in place by the government facilitate TOs to design and implement such systems. The TOs do not select a destination based on Global Sustainable Tourism Council criterion, but rather the selection of destination is mostly demand-based and profit-oriented. The study suggests that corporate profit motive is the sole criterion for decision making and is one of the major causes impeding sustainable tourism in Pakistan. The role of TOs in developing sustainable tourism is vague as the TOs do not have any systems in place to implement sustainable models. The study recommends that efforts need to be put in place to incentivize sustainable tourism in Pakistan and proper laws should be set forth by the authorities to comply by the TOs. The role of TOs is important and understood, however, there is a need to put proper systems in place.

Beekeeping as a family artisan entrepreneurship business

2019 ◽  
Vol 25 (4) ◽  
pp. 717-730 ◽  
Author(s):  
Veland Ramadani ◽  
Robert D. Hisrich ◽  
Leo-Paul Dana ◽  
Ramo Palalic ◽  
Laxman Panthi
Keyword(s):  
Family Business ◽  
Transition Economy ◽  
Rural Families ◽  
Research Approach ◽  
Full Time ◽  
Western Balkans ◽  
Content Type ◽  
Face To Face ◽  
Part Time ◽  
Depth Interviews

Purpose Throughout Macedonia, beekeeping is becoming popular regardless of ethnicity. Studying ethnicity, the purpose of this paper is to determine what beekeepers in Macedonia thought in their own words about their beekeeping entrepreneurship. The objective is to identify whether motivations of ethnic Albanian beekeepers in Macedonia were the same or different compared to those of ethnic Macedonians in the same country, and if different, how. Design/methodology/approach To accomplish this objective, in-depth interviews were conducted with 40 beekeepers in Macedonia. A total of 29 interviews were conducted face-to-face and the other 11 by phone. The first set of interviews took place between December 2016 and February 2017, followed by more interviews in June 2017. In total, 27 respondents said they were ethnic Albanians, and 13 identified themselves as ethnic Macedonians. Also, ten respondents were women. While eight were full-time beekeepers, 32 were part-time beekeepers. Findings The results indicated that beekeeping businesses play a significant role in the transition economy of Macedonia. Beekeeping provides additional earnings that support rural families and keeps them financially stable. The majority of both Albanians and Macedonians understood that beekeeping on a part-time job basis provided a needed supplement to their income. Some part-time beekeepers are also working as auto-mechanics, locksmiths, medical doctors, restaurant/cafeteria owners, and tailors. A few in the sample were retired from their jobs or full-time beekeepers. An important difference between ethnic Albanian beekeepers and ethnic Macedonians in Macedonia is that the majority of ethnic Albanian participants see beekeeping as following in “my father’s footsteps”, while most Macedonians were motivated by the perceived opportunity of having a good business. Research limitations/implications Limitations of the research are twofold. First, financial data of family beekeeping are not available, which would be useful in determining the contribution made to economic development. It is common, especially in transition economies such as the western Balkans, that financial results are very sensitive to their owners. Second, unavailable databases for beekeepers make any quantitative approach difficult, if not impossible, resulting in most research using the qualitative research approach. Originality/value This paper is one of the first to treat beekeeping as a form of artisan entrepreneurship, which also contributes to the understanding of family business. As in other countries, the important and operation of the family business among family members in Macedonia is passed from generation to generation. The results of this research revealed the value of networking, which was found to be very important to income. For beekeepers to develop, grow, and be branded in the community, networking is an important ingredient.

Identifying key network characteristics for agricultural innovation: A multisectoral case study approach

2018 ◽  
Vol 47 (1) ◽  
pp. 19-26
Author(s):  
Evelien Lambrecht ◽  
Maarten Crivits ◽  
Ludwig Lauwers ◽  
Xavier Gellynck
Keyword(s):  
Success Factors ◽  
Knowledge Exchange ◽  
Group Discussions ◽  
Agricultural Innovation ◽  
Network Characteristics ◽  
Face To Face ◽  
Study Approach ◽  
Innovation Characteristics ◽  
Depth Interviews

This article identified network characteristics critical for successful agricutural innovations within networks, or a set of interrelated organizations aiming at knowledge exchange for innovations. To explore key success factors, the research questioned how networks cope with innovation characteristics and combined network characteristics with four innovation characteristics in four agricultural sub-sectors. Data were collected from in-depth interviews with farmers and network coordinators and from focus group discussions with farmers active in Flanders, the northern part of Belgium. Factors particularly helpful for success in agricultural innovation networks include numerous contacts, integration of knowledge providers in the network structure, face-to-face communication, a self-initiated coalition and surpassing innovation beyond the mere agricultural level, through collaboration with people from outside the sector. The findings are useful for academics, network coordinators and network members, possibly leading to a higher innovation performance via networking.

scholarly journals Exploring The Attitudes Towards Patients Diagnosed With Alcohol Use Disorder (AUD) -A Qualitative Study Of Nurses At The National Referral Hospital, Bhutan

2021 ◽  
Vol 4 (2) ◽  
pp. 117-129
Author(s):  
Sangay Chozom ◽  
Florian Neuhann ◽  
Wolfgang Krahl
Keyword(s):  
Recovery Process ◽  
Alcohol Addiction ◽  
Face To Face ◽  
Adequate Knowledge ◽  
Effective Interventions ◽  
Positive Attitudes ◽  
Nursing Courses ◽  
Negative Feelings ◽  
Depth Interviews ◽  
National Referral Hospital

Background: The kind of attitude expressed by the nurses may have significant effect on the recovery process of the patient and on their decision to avail treatment. It is anticipated that by exploring the attitudes of the nurses towards AUD patients and understanding the factors which influences these attitudes, more effective interventions can be developed to provide help and support to this group of patient and also to the nurses in being effective and appropriate in responding to the needs of this group of patient.Purpose: The study was conducted to explore the prevailing attitudes of nurses towards AUD patients, and to further explore the factors influencing these attitudes.Methods: A total of fifteen nurses from Jigme Dorji Wangchuck National Referral Hosiptal were recruited based on convenience and purposive sampling techniques. Qualitative approach was employed by means of conducting face to face in-depth interviews using open ended questions. The qualitative data was analyzed using thematic analysis method.Results: The findings from the study suggest that possessing adequate knowledge on alcohol and addiction, being regularly engaged with AUD patients or having few years of experience working with AUD patients were some of the factors which resulted in more positive attitudes among the nurses. On the contrary, insufficient skills and knowledge related to alcohol addiction and exhibition of aggressive behaviour by the patients could cause negative feelings and ultimately lead to negative attitudes.Conclusion: Therefore, it is of paramount importance that a curriculum on alcohol addiction is introduced in diploma and degree nursing courses offered in Bhutan.

scholarly journals Preventing Non-attendance in Outpatient Appointments: Predictive Model Development, Validation, and Clinical Assessment

2021 ◽  
Author(s):  
Damià Valero-Bover ◽  
Pedro González ◽  
Gerard Carot-Sans ◽  
Isaac Cano ◽  
Pilar Saura ◽  
...  
Keyword(s):  
High Risk ◽  
Model Development ◽  
Intervention Group ◽  
Resource Planning ◽  
Quality Of Healthcare ◽  
Phone Call ◽  
Outpatient Services ◽  
Healthcare Provision ◽  
Predictive Capacity ◽  
Outpatient Appointments

Abstract Background: Non-attendance to scheduled hospital outpatient appointments may compromise healthcare resource planning, which ultimately reduces the quality of healthcare provision by delaying assessments and increasing waiting lists. We developed a model for predicting non-attendance and assessed the effectiveness of an intervention for reducing non-attendance based on the model.Methods: Candidate models were built using retrospective data from appointments scheduled between January 1, 2015, and November 30, 2018, in the dermatology and pneumology outpatient services of the Hospital Municipal de Badalona (Spain). The predictive capacity of the selected model was then validated prospectively with appointments scheduled between January 7 and February 8, 2019. The effectiveness of selective phone call reminders to patients at high risk of non-attendance according to the model was assessed on all consecutive patients with at least one appointment scheduled between February 25 and April 19, 2019. Patients identified by the model as high risk of non-attendance were randomly assigned to either a control (no intervention) or intervention group, the last receiving phone call reminders one week before the appointment.Results: Models were trained and selected using 33,329 appointments in the dermatology service and 21,050 in the pneumology service. Average results for specificity and balanced accuracy for the prediction of non-attendance were 79.90% and 73.49% for dermatology, and 71.38% and 64.61% for pneumology outpatient services. The prospective validation showed a specificity of 78.34% (95%CI 71.07, 84.51) and balanced accuracy of 70.45% for dermatology; and 69.83% (95%CI 60.61, 78.00) for pneumology, respectively. The effectiveness of the intervention was assessed on 1,311 individuals identified as high risk of non-attendance according to the selected model. Overall, the intervention resulted in a significant reduction in the non-attendance rate to both the dermatology and pneumology services, with a decrease of 50.61% (p<0.001) and 39.33% (p=0.048), respectively.Conclusions: The risk of non-attendance can be adequately estimated using patient information stored in medical records. The patient stratification according to the non-attendance risk allows prioritizing interventions, such as phone call reminders, to effectively reduce non-attendance rates.

scholarly journals Parents’ Perception Having Children with Intellectual Disability Providing Sex Education

2017 ◽  
Vol 2 (2) ◽  
pp. 164 ◽  
Author(s):  
Dwi Karina Ariadni ◽  
Yayi Suryo Prabandari ◽  
Sumarni DW
Keyword(s):  
Intellectual Disability ◽  
Sex Education ◽  
Group Discussion ◽  
Phenomenological Approach ◽  
Normal Children ◽  
Face To Face ◽  
Role Of Parents ◽  
Depth Interviews ◽  
Children With Intellectual Disability

Introduction: Children with intellectual disability have the same sexual needs as the average children. Parents are their children’s primary sex educators, but many parents are afraid of talking to their children about sex. The purpose of this study to explore the perception of parents in providing sex education to children with intellectual disability. Methods: A qualitative study using phenomenological approach. Focus group discussion (FGD) and in-depth interviews (face-to-face) with ten parents having children with mild or moderate intellectual disability, aged nine-eighteen years registered at SLB Negeri 1 Yogyakarta. Colaizzi method was used to identify core themes and patterns. Results: Four themes were found: the importance of sex education for children with intellectual disability, the mother has the most important role in providing sex education, the distinction of sex education for children with intellectual disability, religion is important in sex education. Conclusions: Perception of parents in providing sex education to children with intellectual disability is different from parents with normal children. Parents should be earlier deliver sex education to protect them from sex abuse and the method of giving sex education with practice. The role of parents, especially mother is very important to provide sex education than father.

scholarly journals The national broadband network and the challenges of creating connectivity in education: The case of Tasmania

2013 ◽  
Vol 29 (2) ◽  
Author(s):  
Sue Stack ◽  
Jane Watson ◽  
Joan Abbott-Chapman
Keyword(s):  
Information And Communication Technology ◽  
Communication Technology ◽  
New Technologies ◽  
Classroom Teaching ◽  
Technology In Education ◽  
Face To Face ◽  
Innovative Methodology ◽  
Broadband Network ◽  
Information And Communication ◽  
Depth Interviews

<p>Tasmania, one of the first locations to have communities connected to the national broadband network (NBN), provided the context within which to ask significant questions about the implications of the NBN for all levels and sectors of education. This paper reports findings from a research project that developed innovative methodology to explore the issues with 21 respondents categorised as "leaders" in the field of information and communication technology in education. The aim of the research was to conduct an audit of actual and planned implementation of new technologies in classroom teaching through in-depth interviews, to assess challenges faced in implementation and to facilitate dialogue between leaders in disparate education areas through provision of forums online and face-to-face. In this way the action research both contributed to an understanding of issues and acted as a change agent in stimulating the sharing of new approaches to what turned out to be a set of highly complex "wicked" problems. Resulting models using a causal layered approach demonstrate that whereas the NBN did not become the immediate solution to connectivity for these leaders, it provided the motivation to consider what a connected educational environment could be like.</p>

Sign in / Sign up

Export Citation Format

Share Document