scholarly journals On-line memory clinic – piloting a hybrid model

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S225-S225
Author(s):  
Rahul Tomar
Keyword(s):  
Digital Literacy ◽  
Cognitive Test ◽  
Remote Memory ◽  
Limiting Factor ◽  
Memory Clinic ◽  
Improvement Project ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
On Line

AimsQuality improvement project was undertaken to reorganise memory clinic to incorporate both virtual and in-person consultation (Hybrid Virtual model), as depicted in the following model:MethodTele triage conducted to ascertain information from patient and carer. This reduced time for face to face assessment.Nurse did face to face assessment to complete cognitive test (Addenbrooke's Cognitive Examination III) & carer completed Bristol Activities of Daily Living scale. Nurse would also do BP, PR, oxygen sats & temp.Nurse discussed the assessment with the consultant (who is in the inpatient unit) on line using MS TEAMSConsultant would then see patient on line, confirm diagnosis, answer questions, give information on medication and post prescription (if required)Feedback was collected using Telehealth Satisfaction questionnaireResultHybrid remote memory clinic was started on 29/09/20. A total of 37 patients were seen in this clinic by 31/01/21.Collected feedback from 21 patients was generally positive –Information provided on video consultation prior to assessment -18 reported it as excellentHow well you privacy was respected – 21 reported it as excellent.Information you received on the treatment – 18 reported it as excellentConclusionThe hybrid remote memory clinic was more effective than telephone consultation or on line only consultation as it was –Easy to establishing rapportPhysical examination could be performedDigital literacy was no longer a limiting factorPrescribing medication was slightly more difficult but possible

scholarly journals Feasibility of remote Memory Clinics using the plan, do, study, act (PDSA) cycle

2021 ◽  
Author(s):  
Jemima T Collins ◽  
Biju Mohamed ◽  
Antony Bayer
Keyword(s):  
Remote Memory ◽  
Service Improvement ◽  
Attendance Rate ◽  
Memory Clinic ◽  
Improvement Project ◽  
Face To Face ◽  
Pdsa Cycle ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
To Come

Abstract Introduction A timely diagnosis of dementia is crucial for initiating and maintaining support for people living with dementia. The coronavirus disease (COVID) pandemic temporarily halted Memory Clinics, where this is organised, and rate of dementia diagnosis has fallen. Despite increasing use of alternatives to face-to-face (F2F) consultations in other departments, it is unclear whether this is feasible within the traditional Memory Clinic model. Aims The main aim of this service improvement project performed during the pandemic was to explore feasibility of telephone (TC) and videoconference (VC) Memory Clinic consultations. Methods Consecutive patients on the Memory Clinic waiting list were telephoned and offered an initial appointment by VC or TC. Data extracted included: age, internet-enabled device ownership, reason for and choice of Memory Clinic assessment. We noted Montreal Cognitive Assessment-Blind (TC) and Addenbrooke’s Cognitive Examination-III (VC via Attend Anywhere) scores, and feasibility of consultation. Results Out of 100 patients, 12 had a home assessment, moved away, been hospitalised, or died. 45, 21 and 6 preferred F2F, VC and TC assessments respectively. 16 were not contactable and offered a F2F appointment. The main reason for preferring F2F was non-ownership, or inability to use an internet-enabled device (80%). VC and TC preference reasons were unwillingness to come to hospital (59%), and convenience (41%). Attendance rate was 100% for VC and TC, but 77% for F2F. Feasibility (successful consultations) was seen in 90% (VC) and 67% (TC) patients. Conclusion For able and willing patients, remote Memory Consultations can be both feasible and beneficial. This has implications for future planning in dementia services.

scholarly journals Patient satisfaction from ENT telephone consultations during the coronavirus disease 2019 pandemic

2020 ◽  
pp. 1-6 ◽  
Author(s):  
M Zammit ◽  
R Siau ◽  
C Williams ◽  
A Hussein
Keyword(s):  
Patient Satisfaction ◽  
Improve Patient Satisfaction ◽  
Improvement Project ◽  
Telephone Consultation ◽  
Face To Face ◽  
Consultation Model ◽  
Patient Questionnaires ◽  
Potential Benefits ◽  
Improve Patient ◽  
Initial Results

Abstract Background Telephone consultations have rapidly increased in the out-patient setting because of the coronavirus pandemic. A quality improvement project was implemented to improve patient satisfaction of telephone consultations in our unit. Methods This was a prospective complete-cycle project. Patient satisfaction questionnaires were sent to patients following telephone consultations in ENT clinics. Based on a literature review and initial results, clinicians were encouraged to follow a structured consultation format. A second questionnaire survey was conducted following its implementation. Results One hundred patient questionnaires were collected during the survey (April and June 2020). There was significant improvement over the two surveys in terms of satisfaction scores (p = 0.026), along with a significantly increased preference for telephone consultations over face-to-face consultations (p = 0.021). Conclusion This study showed significant improvement in patient satisfaction and an increased telephone consultation preference through the use of a structured consultation model. The potential benefits in terms of infection control and impact on out-patient workload may see telephone consultations persist in the post-coronavirus era.

scholarly journals P066 Telephone clinics: what are our patients saying?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Muhammad Azhar Abdullah ◽  
Nicholas Heng ◽  
Sajjad Noor ◽  
Urooj Ahmed ◽  
Clare Lavery ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Action Plan ◽  
Phone Call ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
Patient Groups ◽  
To Receive ◽  
Good Patient Satisfaction

Abstract Background/Aims  Telemedicine has not previously been a regular part of routine rheumatology services.Our department adopted telephone clinics during the COVID-19 pandemic. We assessed patient satisfaction by conducting a feedback survey. Our aim was to obtain a patient perspective on remote consultations and on preferred future follow up options including video or face-to-face consultations. Methods  The cohort included 160 rheumatology patients who had a telephone consultation between May and mid-June 2020. All patients consented to receive a further phone call by a different member of the team. Patients had to answer a questionnaire about recent consultation and to rate this on a scale of 1-5. Other questions included whether all their queries were answered; clear action plan made; perceived benefits or disadvantages of telephone consultation; and views about future follow up and any additional comments. Results  71.9% of 160 patients were females while 28.1 % males. Mean age 58.6 yrs. More than half of the patients (60.6%) had a diagnosis of inflammatory arthritis, followed by connective tissue disease (19.3%), other diagnosis (8.1% ) & vasculitis (5.6%). 94.4 % of the patients in this study were return appointments-the remainder new. Feedback results revealed 92.5% patients were satisfied with their consultation with mean score of 4.3/5 (5=best,1= worst). More than 80% agreed that all their queries were answered and a clear action plan was formed during consultation. However ,71.2% would want a face to face consultation if given choice while 54 % happy to have further follow up over the phone. 65% of patients preferred not to have video consultation. Subgroup analysis showed that majority of patients who would accept video consultation were aged between 30-39. Most common benefits described were noted to be convenience; reduced time of work; travel time and safety during pandemic, whilst difficulty in describing symptoms; hearing problems; and severity of disease were disadvantages raised, but numbers were small in our cohort. Conclusion  Telephone clinics were the mainstay during the COVID-19 pandemic.The large majority of the rheumatology patients in our cohort were highly satisfied with this form of consultation. However, interestingly the majority (71% ) would still prefer face-to-face consultation as follow up in the future. Regular follow up in carefully selected patient groups can successfully be performed by telephone clinics with good patient satisfaction. This would help increase capacity within the clinic setting. Disclosure  M. Abdullah: None. N. Heng: None. S. Noor: None. U. Ahmed: None. C. Lavery: None. S. Bawa: None.

scholarly journals Live Learning: Online Teaching, Digital Literacy and the Practice of Inquiry

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Leo Casey ◽  
Michael Hallissy
Keyword(s):  
Higher Education ◽  
Digital Literacy ◽  
Classroom Practice ◽  
Online Teaching ◽  
Teaching And Learning ◽  
New Technology ◽  
Learning Space ◽  
Technology System ◽  
Face To Face ◽  
On Line

There has been significant discussion in recent times around improving the quality of teaching and learning in higher education (Laycock, 2009; Laurillard & Masterman, 2010; DES, 2010).  The Lisbon Strategy (Commission to the Council and the European Parliament, 2006) has framed much of this discussion at a European level with individual countries, such as Ireland, developing their own-targeted strategies to expand and improve higher education (DES, 2010).  In the case of Ireland, these strategies specifically mention the need for institutions to provide ‘excellent teaching’ whether in face-to-face or online settings.  Whereas there is a significant body of on-going research conducted around effective teaching in traditional, face-to-face settings in higher education (for example, Bennett & Barp, 2008, Beetham & Sharpe, 2007) there is, in recent times, an emerging need for investigations that focus on new contexts for teaching particularly in online synchronous classrooms.Many institutions have invested substantial time and resources in procuring new technology systems to support on-line teaching and in training staff to operate the many varied functions within these technologies.  However, there is also a need to go beyond mere functionality and to provide deeper pedagogical support to faculty so they can fully realise the instructional potential of these systems (Kim & Bonk, 2006; Lee & Hirumi, 2004).  Technological innovations in the area of online teaching lead to new challenges for teachers and educators as new tools are developed and adopted by their institutions. A question for researchers is the extent to which these tools augment or inhibit existing roles and practices in the classroom and to ask how we can conceptualize learning and teaching in such contexts.The case for considering inquiry learning as the ‘telos’ or central purpose of classroom practice is presented here. In this way the live on-line classroom is conceived as a communal learning space where teacher and students participate in activities that are enabled, sustained and enriched by the functionality of the technology system.

scholarly journals P101 Remote risk stratification of dyspnoea in acute respiratory disorders and applications for COVID-19 and future pandemics: a systematic review of the literature

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Catherine Dominic ◽  
Yuti Khare ◽  
Anuradha Ponnapalli ◽  
Shivani Ganesh ◽  
Gaurav Bhalla ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Respiratory Distress ◽  
Severe Respiratory Distress ◽  
Respiratory Disorders ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
Video Telephone ◽  
Remote Assessment ◽  
Liver Transplant Recipients

Abstract Background Due to the highly infectious nature of the disease, a large amount of community-based triage of COVID-19 is performed by video/telephone consultation, especially in primary care. This presented clinicians with a new challenge in risk stratification of patients with dyspnoea due to suspected COVID19. This review searched existing literature to identify existing modalities to remotely assess patients with acute respiratory distress, which can be adapted for the COVID-19 pandemic and in future similar situations. Methods We conducted a systematic search of Medline, Embase and Medrxiv for studies of the remote assessment of dyspnoea in acute respiratory disorders in adults/children. The study was registered on PROSPERO (ID: CRD42020202292): 3014 abstracts were screened independently by two reviewers and 32 studies were progressed to full text screening. Results Five studies were selected for review, including 1317 patients. Two studies assessed video consultation, two assessed telephone related triage tools, and one study assessed an online triage tool for dyspnoea. In one study, video consultation was found to have 83% sensitivity for diagnosing ‘severe’ respiratory distress in comparison to face-to-face assessment. The online triage tool was found to have 87.5% sensitivity for detecting dyspnoea requiring emergency level care. Conclusion A range of successful remote risk stratification tools and clinical features were identified for assessing dyspnoea severity which can be adapted to COVID-19 and future pandemics to assess respiratory distress via telemedicine. These findings will influence development of comprehensive evidence-based tools to assess dyspnoea which will reduce resource strain during current/future pandemics. References Loinaz C, Marcacuzco A, Fernández-Ruiz M, Caso O, Cambra F, San Juan R, et al. Varied clinical presentation and outcome of SARS-CoV-2 infection in liver transplant recipients: Initial experience at a single center in Madrid, Spain. Transpl Infect Dis Off J Transplant Soc. 2020 Jun 20;e13372.

A Study on Learners’ Readiness and Perceptions of the Implementation of Blended Learning in UiTM Kedah

2019 ◽  
Vol 3 (2) ◽  
pp. 41
Author(s):  
Robekhah Harun ◽  
Zetty Harisha Harun ◽  
Laura Christ Dass
Keyword(s):  
Blended Learning ◽  
Successful Implementation ◽  
Learning Approaches ◽  
Learner Readiness ◽  
Learning And Teaching ◽  
Face To Face ◽  
Online Assessments ◽  
Research Findings ◽  
On Line ◽  
Learning Institutions

The increase in student enrolment and the need  to cater to students of diverse backgrounds have led to the adoption of blended learning in many higher learning institutions. Blended learning, which allows both face to face interaction and on-line delivery, has been adopted into many curricula. One such institution is University Technology MARA which is slowly introducing features of blended learning in its course syllabus beginning with practice to online assessments. However, to ensure successful implementation of blended learning as part of the curricula, there are several aspects for consideration such as learner and teacher readiness for blended learning. This paper examines issues regarding the use of blended learning as a delivery method at UiTM Kedah . The discussion in this paper focuses on learner’ readiness and perceptions of the blended learning environment. The data collected for this study are responses from learners to a questionnaire survey. The research findings form the basis for recommendations for the development of learning and teaching practices using blended learning approaches to enhance learners' learning experiences.  

Patient feedback on a new method of consulting with the GP; an analysis of responses by users of online triage software

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696773
Author(s):  
Abi Eccles ◽  
Mike Hopper ◽  
Helen Atherton
Keyword(s):  
Free Text ◽  
Telephone Consultation ◽  
Face To Face ◽  
Potential Barriers ◽  
Online Consultation ◽  
Patient Feedback ◽  
Levels Of Use ◽  
Negative Perceptions ◽  
Context Dependent ◽  
Feedback Data

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.

scholarly journals 829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Holmes ◽  
U Mirza ◽  
C Manning ◽  
R Cooke ◽  
R Jugdey
Keyword(s):  
Common Theme ◽  
Telephone Triage ◽  
Telephone Consultation ◽  
Face To Face ◽  
Clinician Satisfaction ◽  
Set Up ◽  
Local Protocol ◽  
Telephone Questionnaire

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

scholarly journals Implementation of podiatry telephone appointments for people with rheumatic and musculoskeletal diseases

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
J. L. Palmer ◽  
H. J. Siddle ◽  
A. C. Redmond ◽  
B. Alcacer-Pitarch
Keyword(s):  
Musculoskeletal Diseases ◽  
Cost Effective ◽  
Time Frame ◽  
Teaching Hospitals ◽  
Potential Cost ◽  
Foot Health ◽  
Telephone Consultation ◽  
Face To Face ◽  
Initial Intervention

Abstract Background Foot health problems are common in the general population, and particularly so in people with rheumatic and musculoskeletal disorders (RMD). Several clinical guidelines state that people with RMDs should have access to foot health services, although service capacity is often limited. The current COVID-19 pandemic has increased the need for alternative ways to provide patient care. The aim of this clinical audit was to review a newly implemented telephone follow-up appointment service conducted within the Rheumatology Podiatry Department in Leeds, UK. Methods Fifty-eight patients attending the Rheumatology Podiatry Department at Leeds Teaching Hospitals NHS Trust were contacted by telephone approximately 6–8 weeks following initial intervention. During the telephone consultation, all patients were asked pre-defined questions relating to their symptoms, intervention efficacy, the need for further appointments and their preference for the type of consultation. To assess the cost of the telephone consultation the number of attempts needed in order to make successful contact, the duration of the call and the number of telephone follow-up appointments completed in a working day were also recorded. Results Twenty-five patients (43%) were successfully contacted within the 6–8 weeks stipulated time frame and were included in the analysis. Of the 25 contacted, twelve (48%) patients were successfully contacted on the first attempt. Ten (40%) were successfully contacted on the second attempt. The remaining three patients (12%) required 3 or more attempts to make successful contact. Telephone consultations were estimated not to last longer than 10 min, including notes screening and documentation. Eleven patients (44%) reported an improvement in their symptoms, thirteen (52%) reported no change and one patient (4%) reported their symptoms to be worse. Conclusion Telephone follow-up consultations may be a potentially cost-effective alternative to face-to-face appointments when implemented in a Rheumatology Podiatry Department, and provide an alternative way of providing care, especially when capacity for face-to-face contact is limited. The potential cost saving and efficiency benefits of this service are likely to be enhanced when telephone consultations are pre-arranged with patients.

scholarly journals Spine Examination during COVID-19 Pandemic via Video Consultation

2021 ◽  
Author(s):  
Tom Jansen ◽  
Martin Gathen ◽  
Amadeo Touet ◽  
Hans Goost ◽  
Dieter Christian Wirtz ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Range Of Motion ◽  
Test Results ◽  
Risk Of Infection ◽  
Face To Face ◽  
Reliable Tool ◽  
Provocation Tests ◽  
Active Range Of Motion ◽  
Video Consultation ◽  
Good Agreement

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.

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