An evaluation of service user experience, clinical outcomes and service use associated with urgent care services that utilise telephone-based digital triage: a systematic review protocol

Background Telephone-based digital triage is widely used by services that provide urgent care. This involves a call handler or clinician using a digital triage tool to generate algorithm-based care advice, based on a patient’s symptoms. Advice typically takes the form of signposting within defined levels of urgency to specific services or self-care advice. Despite wide adoption, there is limited evaluation of its impact on service user experience, service use and clinical outcomes; no previous systematic reviews have focussed on services that utilise digital triage, and its impact on these outcome areas within urgent care. This review aims to address this need, particularly now that telephone-based digital triage is well established in healthcare delivery. Methods Studies assessing the impact of telephone-based digital triage on service user experience, health care service use and clinical outcomes will be identified through searches conducted in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus. Search terms using words relating to digital triage and urgent care settings (excluding in-hours general practice) will be used. The review will include all original study types including qualitative, quantitative and mixed methods studies; studies published in the last 20 years and studies published in English. Quality assessment of studies will be conducted using the Mixed Methods Appraisal Tool (MMAT); a narrative synthesis approach will be used to analyse and summarise findings. Discussion This is the first systematic review to evaluate service user experience, service use and clinical outcomes related to the use of telephone-based digital triage in urgent care settings. It will evaluate evidence from studies of wide-ranging designs. The narrative synthesis approach will enable the integration of findings to provide new insights on service delivery. Models of urgent care continue to evolve rapidly, with the emergence of self-triage tools and national help lines. Findings from this review will be presented in a practical format that can feed into the design of digital triage tools, future service design and healthcare policy. Systematic review registration This systematic review is registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO 2020 CRD42020178500).

Service user experience of the Norfolk youth service

Purpose There is an international drive to improve mental health services for young people. This study aims to investigate service user experience of a youth mental health service in Norfolk, UK. In addition to suggesting improvements to this service, recommendations are made for the development of youth mental health services in general. Design/methodology/approach A mixed-methods approach was used. Quantitative data from satisfaction questionnaires were analysed using descriptive statistics and compared between two time points. A semi-structured interview was used to generate qualitative data. Thematic analysis was used to identify themes in the interview transcripts and triangulation was used to synthesise quantitative and qualitative data. Findings Service users appeared satisfied with the service. Significant improvements in satisfaction were found between two time points. Qualitative analysis identified three main themes that were important to service users, including support, information and personhood. Practical implications Recommendations for the development of youth mental health services are provided. Although these are based on findings from the Norfolk youth service, they are likely to apply to other mental health services for young people. Originality/value Mental health care for young people requires significant improvement. The Norfolk youth service is one of the first services of its kind in the UK. The findings from this study might be helpful to consider in the development of youth mental health services across the world.

Measuring the experience of consumers: reliability and factorial structure of the Take Two stakeholder survey

The service user experience of children, their families and other stakeholders in a therapeutic program should inform quality of care, practice and organisation of services. Children referred to Take Two are clients of Child Protection for whom abuse and neglect have been substantiated. This paper aims to describe the development of the Take Two Stakeholder Survey, as well as to examine the reliability and factorial structure of the survey. In addition, the experience of consumers utilising the service will be described together with recommendations for clinical practice improvements and enhanced consumer engagement.

Physical Boundaries and Professional Space

Analysis of feedback from student placements in inter – professional settings suggests that the fault – lines of inter - professional working tend to fall in with physical boundaries in communities, on sites, within buildings, and within the workspace. Furthermore, placement conflict frequently surfaces in spatial issues but solutions when identified are only rarely spatial. By attending more closely to what students say about where on the placement their best and worst practice learning experiences occur, placement co-ordinators and placement agencies can begin to map the practice experience, adding something to their existing knowledge of service user experience and organisational structure.

Turkish-Speaking Service-User Experience of Guided Self-Help in an Improving Access to Psychological Therapies Service: Using Discovery Interviews to Improve Services

Improving Access to Psychological Therapies (IAPT) delivers guided self-help (GSH) interventions in the United Kingdom (UK). A minority service-user group for whom we know little of their engagement with GSH are Turkish-speaking users. The study aimed to better understand Turkish-speaking service-users experience of a GSH intervention in an IAPT service and identify possible service improvements. A discovery interview method facilitated service-users to describe their experience of GSH. Transcripts were analysed thematically. Excerpts of service-user narratives and thematic commonalities across interviews were disseminated in clinical teams and informed service improvements. Participant distress was expressed through somatic complaints, a high level of confusion and inactivity. Engagement with GSH was affected by ambivalent help-seeking and sense of limited self-efficacy. Service improvements aimed to address a widespread sense of confusion and anxiety. Listening to service-user experience provides opportunities for mending communication gaps between services and ethnic minority service-users.