scholarly journals Telemedicine in addictions feasibility RCT – staff and patient qualitative satisfaction

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S297-S297
Author(s):  
Dominic Treloar ◽  
Soraya Mayet
Keyword(s):  
Opioid Dependence ◽  
Health Science ◽  
Feasibility Trial ◽  
Innovative Technology ◽  
Free Text ◽  
Opioid Substitution Treatment ◽  
Good Communication ◽  
Face To Face ◽  
Research Interview ◽  
The Impact

AimsOpioid dependence has high risks. Opioid substitution treatment (OST) improves outcomes. Addiction specialist prescribers prescribe OST and monitor safety, but nonattendance may lead to worse outcomes. Telemedicine can reduce travel and improve attendance at appointments. Before COVID-19, we started a telemedicine in addictions trial to see if this helped in addictions. We present the qualitative patient and staff experience results.MethodHealth Research Authority approval for randomized controlled feasibility trial of Telemedicine versus Face-to-Face (control) consultations at community addictions semirural service (2500km2) using a modified Hub-and-Spoke (outreach) model. Adult opioid dependent patients prescribed OST and attending outreach were recruited. Participants received two appointments in randomized group. Telemedicine was delivered using Skype-for-business videoconferencing. Patients attended outreach, saw keyworker for drug testing first, and telemedicine conducted via keyworker's laptop. Addiction prescribers located remotely at Hub. Post-trial research interview conducted assessing patient and staff experience of Telemedicine versus Face-to-Face consultations. Data transcribed, inputted to RedCap Cloud and free-text analysed using qualitative thematic analysis.ResultOf fifty-nine patient participants, 58 completed a research interview. Patient participants reported similar levels of satisfaction between the Telemedicine and Face to Face groups. The themes generated in relation to Face-to-Face were no difference, easy, kind staff and liking being part of research. For Telemedicine, themes were less travel, good experience, easier to access, good communication, saves time and saves money. For instance, one patient stated ‘Clear, easy to access less travel’ and another patient stated ‘I struggle with travel. I found it easier’. Of 19 staff participant research interviews completed, Staff reported Good or Very Good experience with telemedicine which was equivalent for Face-to-Face consultations. Eleven staff had experience of telemedicine consultations during the trial. They reported similar themes to patients with telemedicine leading to less travel, beneficial to patient care, improves attendance and was innovative technology. One staff member reported satisfaction with telemedicine due to ‘Time, travel and money reduction’. When questioned on the downsides to telemedicine, technological issues were mainly related to connection issues and sound issues.ConclusionIn the first known RCT of Telemedicine versus Face-to-Face consultations for patients with opioid dependence attending prescriber review, we found that both patients and staff were satisfied with telemedicine as compared to face-to-face consultations. Overall themes were reduced travel, saving time and more convenience. This will be very important given the impact of COVID-19 on access to addictions services.Financial SponsorshipEast Riding CCGAcademic Health Science Network

scholarly journals Addiction service changes due to COVID-19

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S349-S349
Author(s):  
Shumaila Shahbaz ◽  
Zeeshan Hashmani ◽  
Soraya Mayet
Keyword(s):  
Opioid Dependence ◽  
Data Retrieval ◽  
Service Evaluation ◽  
Individual Risk ◽  
Attendance Rates ◽  
Opioid Substitution Treatment ◽  
Face To Face ◽  
Addiction Service ◽  
The Individual ◽  
Opioid Substitution

AimsAddictions services had to respond rapidly to reduce COVID-19 transmission to protect patients and staff. Patients with opioid dependence are particularly vulnerable, with high risks. Our community addiction service changed practice in line with COVID-19 guidelines. For patients with opioid dependence; face-to-face contacts were initially reduce and mainly for new starts, restarts and non-attenders. Prescribing changes were completed on an individually risk assessed basis to reduce attendance at the chemist, specifically to reduce transmission, keep patients in treatment and to ensure chemists could continue to function. We document some of the service changes during the COVID-19 lockdown.MethodService evaluation had approval from Humber Teaching NHS Foundation Trust. Data retrieved on one Hub of a community addictions service in North England, UK. Patients prescribed opioid substitution treatment for opioid dependence were assessed, with data retrieval through electronic healthcare records. Data were analysed by Microsoft Excel anonymously.ResultIn lockdown (March 2020 to June 2020), we identified 112 patients with opioid dependence prescribed opioid substitution (OST) with methadone or buprenorphine at the Hub. All white British, mean 42 years, most male (75%) and prescribed methadone (78%). Ten were new starts and 8 restarts to OST. Attendance rates did not change: 91% before and 92% during lockdown. Appointment format changed from predominantly face-to-face (92%) to telephone (99%). Most patients (91%;n = 88) were offered take-home naloxone and overdose prevention training of which 14 refused. Supervision days at the chemist for OST reduced significantly from 75% collecting daily at the chemist, reducing to 20% during lockdown. Five patients were shielding and 7 had covid-related symptoms. There was one death during lockdown which was not attributed to covid or overdose.ConclusionThe addictions service continued to be open and work proactively throughout lockdown, seeing new patients and continuing treatment interventions safely. Major changes were made in line with COVID-19 guidelines, to respond to the threat of transmission. Our service was flexible and able to adapt quickly to remote working. We maintained excellent attendance rates despite changes to the format of consultations. There were no related incidents e.g. overdoses linked to prescribed medications, despite a reduction in supervision, and therefore patients having extra medications. This important finding may be related to the individual risk assessments that we conducted before making changing to prescribing. This was supported by most patients were receiving naloxone to prevent overdoses. Some of the changes, such as telephone consultations, may be beneficial to continue post COVID-19.

scholarly journals Post-COVID-19 Adaptations; the Shifts Towards Online Learning, Hybrid Course Delivery and the Implications for Biosciences Courses in the Higher Education Setting

2021 ◽  
Vol 6 ◽  
Author(s):  
Amreen Bashir ◽  
Shahreen Bashir ◽  
Karan Rana ◽  
Peter Lambert ◽  
Ann Vernallis
Keyword(s):  
Higher Education ◽  
Online Survey ◽  
Course Delivery ◽  
Space Environment ◽  
Mental Wellbeing ◽  
Free Text ◽  
Hybrid Course ◽  
Face To Face ◽  
Working Space ◽  
The Impact

The Covid-19 pandemic has created challenges and caused disruption across the Higher Education sector; university campuses closed, and face-to-face teaching and assessment shifted to an online format. Learning from our students’ experience during this period will help us shape future hybrid delivery so that it best fits Bioscience students. This pedagogical study explored Aston University’s Bioscience students’ experiences of studying from home, and the impact of the lockdown on mental wellbeing and quality of life. 151 students completed an online survey during August 2020, which included open and closed questions. Analysis of survey data revealed that a majority of students reported positive experiences of online open-book assessments and most would welcome this format in the future. The majority of students faced no technical issues, predominantly stating that they also had good internet connectivity. Shifting to remote learning and online classrooms uncovered conflicting preferences; despite wanting more interactive lectures, only half of the students were comfortable interacting using video cameras. Free text responses provided an insight into how some students reported an inadequate home working space/environment and lacked necessary items such as a desk, highlighting how remote working may intensify social and digital inequality - particularly for students from more deprived households. Wider detrimental experiences of lockdown included dissatisfaction with access to healthcare, decreased concentration, sleeping difficulties and a decline in mental wellbeing. Education strategies going forward will need to address the mental health needs of students who have suffered during the pandemic. Our university, amongst others, is embracing hybrid course delivery, which could offer a solution to ensuring Bioscience students receive hands-on laboratory experience and face-to-face contact to remain motivated and benefit from the on-campus facilities and support, whilst allowing students some of the flexibility afforded by remote study. In the current competitive higher education market where student retention is key, it is important to consider student demographics and digital equity to ensure an appropriate approach is applied to cater for all students.

scholarly journals Patient experience of telemedicine in addictions

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S269-S270
Author(s):  
Soraya Mayet ◽  
Iain Mccaw ◽  
Zeeshan Hashmani ◽  
Zuzana Drozdova ◽  
Amelia Gledhill ◽  
...  
Keyword(s):  
Patient Experience ◽  
Rural Areas ◽  
Opioid Dependence ◽  
Controlled Trial ◽  
Free Text ◽  
Outreach Worker ◽  
Substitution Treatment ◽  
Opioid Substitution Treatment ◽  
Telemedicine Service ◽  
Opioid Substitution

AimsOpioid dependence has high risks and opioid substitution treatment (OST) improves outcomes and reduces deaths. Attendance at addiction specialist prescribers may be limited, particularly in rural areas. Telemedicine, such as videoconferencing, can reduce travel and improve access and attendance. Pre-COVID-19, we started a telemedicine service for patients with opioid dependence, prescribed opioid substitution treatment, requiring addiction specialist prescriber consultations. We present patient experience and assess whether patients recommend telemedicine.MethodHealth Research Authority approval for Randomized Controlled Trial of Telemedicine versus Face-to-Face (control) appointments in large semi-rural community addictions service (2500km2) using a modified Hub-and-Spoke (outreach). Adult opioid dependent patients prescribed OST and attending outreach clinics recruited. Participants received two consultations in group. Telemedicine delivered using Skype-for-business videoconferencing. Patients attended outreach clinic, where an outreach worker undertook drug testing and telemedicine conducted via the outreach workers laptop. Specialist addiction prescribers located remotely, at the Hub. Patients self-completed NHS Friends and Family Test (FFT) immediately after appointment, separate from the wider research study. Data collected Sept 2019– March 2020 (pre-COVID-19 lockdown), Microsoft Excel analysis, with qualitative thematic free-text analysis.ResultThirty completed FFTs were received, of which all participants were ‘extremely likely’ (n = 19;67%) or ‘likely’ (n = 11;37%) to recommend the Telemedicine service to friends or family, if they needed similar care. Two themes for reasons for recommending the service were; 1. Convenience (reduced travel, reduced travel time and reduced travel costs) and 2. Supportive Staff (including listening, caring and good support). One patient mentioned ‘it is a convenient way to communicate with medical staff, saving time and effort’. Regarding Telemedicine appointments, most participants responded that the timing of telemedicine appointments was good (n = 26;87%), given enough information (n = 30;100%), enough privacy (n = 28;93%), enough time to talk (n = 30;100%), involved as much as they wanted (n = 25;83%), given advice on keeping well (n = 28;93%), and NHS staff were friendly and helpful (n = 29;97%). No participants thought they were treated unfairly. When asked what went well, patient themes were: 1. Everything and 2. Communication (including listening and explaining). One patient stated ‘Everything better, telemedicing good, heard it well, everything improved this year’. In terms of what the service could do better, there were no issues identified.ConclusionThe Telemedicine in Addictions service was overwhelmingly highly recommended by patients. Patients recommended the service because of convenience and supportive staff. The use of telemedicine is acceptable to patients and could be considered more widely. Due to COVID-19, this technology may be beneficial access to addiction services.

scholarly journals The Impact of Misuse and Diversion of Opioid Substitution Treatment Medicines: Evidence Review and Expert Consensus

2015 ◽  
Vol 22 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Jens Reimer ◽  
Nat Wright ◽  
Lorenzo Somaini ◽  
Carlos Roncero ◽  
Icro Maremmani ◽  
...  
Keyword(s):  
Criminal Behavior ◽  
Opioid Dependence ◽  
Direct Impact ◽  
Substitution Treatment ◽  
Negative Effects ◽  
Opioid Substitution Treatment ◽  
Controlled Drugs ◽  
The Individual ◽  
The Impact ◽  
Opioid Substitution

Background/Aims: Opioid substitution treatment (OST) improves outcomes in opioid dependence. However, controlled drugs used in treatment may be misused or diverted, resulting in negative treatment outcomes. This review defines a framework to assess the impact of misuse and diversion. Methods: A systematic review of published studies of misuse and diversion of OST medicines was completed; this evidence was paired with expert real-world experience to better understand the impact of misuse and diversion on the individual and on society. Results: Direct impact to the individual includes failure to progress in recovery and negative effects on health (overdose, health risks associated with injecting behaviour). Diversion of OST has impacts on a community that is beyond the intended OST recipient. The direct impact includes risk to others (unsupervised use; unintended exposure of children to diverted medication) and drug-related criminal behavior. The indirect impact includes the economic costs of untreated opioid dependence, crime and loss of productivity. Conclusion: While treatment for opioid dependence is essential and must be supported, it is vital to reduce misuse and diversion while ensuring the best possible care. Understanding the impact of OST misuse and diversion is key to defining strategies to address these issues.

Patient Perception of remote, digital NHS healthcare during the COVID-19 pandemic: a UK-wide survey (Preprint)

2020 ◽  
Author(s):  
Rehan Symonds ◽  
John Tredinnick-Rowe ◽  
Sebastian Stevens ◽  
Oliver Sleeman
Keyword(s):  
Healthcare Services ◽  
Patient Perception ◽  
User Preference ◽  
Free Text ◽  
Remote Consultation ◽  
Face To Face ◽  
Remote Healthcare ◽  
The Uk ◽  
Survey Responses ◽  
The Impact

BACKGROUND During the early spring of 2020, the use of remote healthcare services in the UK saw a dramatic increase in usage as services transitioned away from face-to-face delivery due to the risk of contracting COVID-19. While by far the largest shift was to telephone access which has been studied in recent years pre-COVID (Campbell, 2014), we wanted to determine the impact on patients of any shift to digital access (via an online consultation using a webcam, laptop, mobile phone application). We therefore commissioned a UK-wide representative survey of patient use and attitudes towards digital remote healthcare during the peak of the 2020 COVID-19 Pandemic in the UK. This report predominantly focuses on primary care as it accounts for 300 million NHS patient contacts each year. OBJECTIVE To rapidly assess patient attitudes towards the use of digital healthcare methods during the COVID-19 pandemic via a representative UK-wide survey. METHODS 2,138 survey responses were analysed against the respondents’ protected characteristics, social status, working status, location (UK region), social media usage and number of children (if any) in their household. Inferential statistics were used to compare these variables and survey responses. The survey consisted of three questions. 2,129 free text responses were thematically analysed from the survey, using an inductive, rapid coding method. RESULTS Initially, 14 themes arose from the data. These were collapsed into 7 parent themes with a smaller number of subtopics. These themes represent patient concern and experience of digital, remote healthcare, (1) Remote healthcare is a lesser service, (2) Useful but only for certain conditions, (3) No preference between face-to-face and remote healthcare. (4) Ease of Access to remote healthcare, (5) Speed of Access to Remote Healthcare. (6) Safety Concerns and Remote Healthcare, and (7) Remote healthcare is better than face-to-face. In summary, current patient perception of remote healthcare is that it is a lesser service, compared to face-to-face delivery. Quantitative results indicate 26% of respondents had used a digital, remote consultation. Users were more likely to be females and in a higher social grade. The largest correlation (Cramer’s V 0.51) between variables was across patients who did not see the benefits of digital, remote consultation but who were willing to use it for safety reasons due to the COVID-19 pandemic. CONCLUSIONS Patient preference for using digital, remote healthcare comes with a series of caveats that practitioners and commissioners should be aware of as the active engagement of patients in remote working appears to be more complex than simple measures of technical ability. The survey data intimates issues around willingness, trust, user-preference and more basic behavioural traits that may not have been factored into the delivery of digital care so far. In short, capacity to act is not well equated to willingness or free will of individuals, least of all acceptance of digital, remote healthcare in any universal form. Our data indicates the need for a psychology-based understanding of the frictions and enablers to remote healthcare, rather than a more narrow assessment of technical capacity if we are to drive behaviour change and help shape effective policy. CLINICALTRIAL n/a

scholarly journals Feasibility, acceptability and effectiveness of an online alternative to face-to-face consultation in general practice: a mixed-methods study of webGP in six Devon practices

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018688 ◽  
Author(s):  
Mary Carter ◽  
Emily Fletcher ◽  
Anna Sansom ◽  
Fiona C Warren ◽  
John L Campbell
Keyword(s):  
Mixed Methods ◽  
Case Reports ◽  
Postal Survey ◽  
Full Potential ◽  
Cross Sectional ◽  
Practice Staff ◽  
Good Communication ◽  
Face To Face ◽  
General Practices ◽  
The Impact

ObjectivesTo evaluate the feasibility, acceptability and effectiveness of webGP as piloted by six general practices.MethodsMixed-methods evaluation, including data extraction from practice databases, general practitioner (GP) completion of case reports, patient questionnaires and staff interviews.SettingGeneral practices in NHS Northern, Eastern and Western Devon Clinical Commissioning Group’s area approximately 6 months after implementing webGP (February–July 2016).ParticipantsSix practices provided consultations data; 20 GPs completed case reports (regarding 61 e-consults); 81 patients completed questionnaires; 5 GPs and 5 administrators were interviewed.Outcome measuresAttitudes and experiences of practice staff and patients regarding webGP.ResultsWebGP uptake during the evaluation was small, showing no discernible impact on practice workload. The completeness of cross-sectional data on consultation workload varied between practices.GPs judged 41/61 (72%) of webGP requests to require a face-to-face or telephone consultation. Introducing webGP appeared to be associated with shifts in responsibility and workload between practice staff and between practices and patients.81/231 patients completed a postal survey (35.1% response rate). E-Consulters were somewhat younger and more likely to be employed than face-to-face respondents. WebGP appeared broadly acceptable to patients regarding timeliness and quality/experience of care provided. Similar problems were presented by all respondents. Both groups appeared equally familiar with other practice online services; e-consulters were somewhat more likely to have used them.From semistructured staff interviews, it appeared that, while largely acceptable within practice, introducing e-consults had potential for adverse interactions with pre-existing practice systems.ConclusionsThere is potential to assess the impact of new systems on consultation patterns by extracting routine data from practice databases. Staff and patients noticed subtle changes to responsibilities associated with online options. Greater uptake requires good communication between practice and patients, and organisation of systems to avoid conflicts and misuse. Further research is required to evaluate the full potential of webGP in managing practice workload.

scholarly journals Impact of E-Learning on Learning Mandarin in Elementary Schools During Covid-19

2021 ◽  
Vol 15 (1) ◽  
pp. 19-24
Author(s):  
Yi Ying ◽  
Paulina Paulina ◽  
Yorika Rovemia Mulyadani ◽  
Krystl Marie O. Lim
Keyword(s):  
Elementary School ◽  
Learning Process ◽  
Teaching And Learning ◽  
Learning Methods ◽  
Good Communication ◽  
Face To Face ◽  
Teachers And Students ◽  
E Learning ◽  
The Right ◽  
The Impact

In the teaching and learning process, the roles of teachers and students will be balanced if there is good communication between them. However, learning methods from face-to-face to e-learning suddenly prompt the teachers to look for various alternatives to convey the material due to COVID-19 pandemic. The research analyzes the impact of COVID-19 on the learning process, especially Mandarin, in an elementary school. The research uses a descriptive-analytical method with questionnaires. The questionnaires are filled out by 34 students from the fifth grade in Bina Kusuma Elementary School, Jakarta. The research finds the positive impacts of elearning in the school regarding Mandarin learning. First, the subject is more interesting and easier to understand. Second, students can learn the right notes and pronunciation independently. Third, using WhatsApp and Zoom can help students recall previously learned vocabulary. Fourth, students can learn new vocabulary independently. Fifth, e-learning can motivate students to learn and gain experience from new learning methods. Sixth, students can manage their time in learning, so they become more independent. Last, students can study anywhere and anytime without time and space limits. However, the weakness of e-learning is the speed of the internet. It affects the students in obtaining the provided subject by the teachers.

Transitioning to Blended Learning: Understanding Student and Faculty Perceptions

2011 ◽  
Vol 15 (1) ◽  
Author(s):  
Nanette P. Napier ◽  
Sonal Dekhane ◽  
Stella Smith
Keyword(s):  
Blended Learning ◽  
Student Performance ◽  
Liberal Arts ◽  
Faculty Perceptions ◽  
Liberal Arts College ◽  
Final Exam ◽  
Face To Face ◽  
Faculty Teaching ◽  
Face To Face Instruction ◽  
The Impact

This paper describes the conversion of an introductory computing course to the blended learning model at a small, public liberal arts college. Blended learning significantly reduces face-to-face instruction by incorporating rich, online learning experiences. To assess the impact of blended learning on students, survey data was collected at the midpoint and end of semester, and student performance on the final exam was compared in traditional and blended learning sections. To capture faculty perspectives on teaching blended learning courses, written reflections and discussions from faculty teaching blended learning sections were analyzed. Results indicate that student performance in the traditional and blended learning sections of the course were comparable and that students reported high levels of interaction with their instructor. Faculty teaching the course share insights on transitioning to the blended learning format.

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.

“New Normal”: Analisis Penerimaan Menggunakan Balance Score Card

2020 ◽  
Vol 3 (2) ◽  
pp. 396-402
Author(s):  
Maria Florentina Rumba ◽  
Margaretha P.N Rozady ◽  
Theresia W. Mado
Keyword(s):  
Higher Education ◽  
Higher Education Institutions ◽  
Normal Phase ◽  
Physical Contact ◽  
New Normal ◽  
Face To Face ◽  
Balance Score Card ◽  
Score Card ◽  
Pros And Cons ◽  
The Impact

Abstrak: Kebiasaan manusia berubah karena adanya wabah COVID-19, hal ini berpengaruh ketika manusia masuk ke dalam fase new normal. New normal diartikan sebagai keadaan yang tidak biasa dilakukan sebelumnya, yang kemudian dijadikan sebagai standar atau kebiasaan baru yang mesti dilakukan manusia untuk dirinya sendiri maupun untuk bersosialisasi dengan orang lain. Kebiasaan baru ini pun menimbulkan pro dan kontra seiring dengan dampak yang timbul. Lembaga pendidikan tinggi merupakan salah satu yang merasakan dampak penerapan new normal. Perkuliahan yang selama ini dilakukan secara online/daring, akan kembali dilakukan secara luring/tatap muka, dengan tetap menerapkan protokol COVID-19 seperti mengenakan masker, menjaga jarak, mengenakan sarung tangan, serta tidak melakukan kontak fisik seperti berjabat tangan. Masalah yang muncul bukan hanya kecemasan orang tua terhadap anak – anaknya, tetapi bagaimana lembaga pendidikan tinggi mengatur segala sumber daya yang dimiliki agar memenuhi standar penerapan new normal. penelitian ini bertujuan untuk mengetahui penerimaan  terhadap kondisi normal yang baru menggunakan Perspektif balance score card. Abstract: Human habits change because of the COVID-19 outbreak, this affects when humans enter the new normal phase. New normal is defined as a condition that is not normally done before, which is then used as a standard or new habits that must be done by humans for themselves or to socialize with others. This new habit also raises the pros and cons along with the impact arising with the new normal. Higher education institutions are the ones who feel the impact of implementing new normal. Lectures that have been conducted online / online will be re-done offline / face to face, while still applying the COVID-19 protocol such as wearing a mask, keeping a distance, wearing gloves, and not making physical contact such as shaking hands. The problem that arises is not only parents' anxiety about their children, but how higher education institutions regulate all available resources to meet new normal implementation standards. This study aims to determine acceptance of new normal conditions using the balance score card Perspective.

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