Department of Surgery, Connolly Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland
Department of General Surgery, Connolly Hospital, Dublin, Ireland.
BMJ Qual Saf. 2019 Jan;28(1):24-31. doi: 10.1136/bmjqs-2018-008171. Epub 2018 Oct 5.
It is standard practice to review all patients following discharge at a follow-up clinic but demands on all health services outweigh resources and unnecessary review appointments may delay or deny access to patients with greater needs.
This randomised trial aimed to establish whether a virtual outpatient clinic (VOPC) was an acceptable alternative to an actual outpatient clinic (OPC) attendance for a broad range of general surgical patients following a hospital admission.
All patients admitted under one general surgical service over the study period were assessed. If eligible for inclusion the rationale, randomisation and follow-up methods were explained, consent was sought and patients randomised to receive either a VOPC or an OPC appointment.
Two-hundred and nine patients consented to study inclusion, of which 98/107 (91.6%) in the VOPC group and 83/102 (81.4%) in the OPC group were successfully contacted. Only 6 patients in the OPC group and 10 in the VOPC group reported ongoing issues. A further follow-up indicated 78 of 82 (95%) VOPC patients were very happy with their overall experience compared with 34/61 (56%) in the actual OPC group (p<0.001). A significant proportion of both cohorts-68/82 (83%) in VOPC group and 41/61 (67%) in OPC group (p = 0.029)-preferred a VOPC appointment as their future follow-up of choice.
The majority of patients discharged from a surgical service could be better followed up by a virtual clinic with a significant proportion of patients reporting a preference for and a greater satisfaction with such a service.
在随访诊所对所有出院患者进行复查是标准做法,但所有卫生服务的需求都超过了资源,不必要的复查预约可能会延迟或拒绝为有更大需求的患者提供服务。
本随机试验旨在确定虚拟门诊(VOPC)是否可以作为一种替代实际门诊(OPC)的方式,用于广泛的普通外科患者在住院后进行随访。
研究期间评估了所有在一个普通外科服务下入院的患者。如果符合纳入标准,将解释纳入的理由、随机化和随访方法,征求同意,并对患者进行随机分组,接受 VOPC 或 OPC 预约。
共有 209 名患者同意参与研究,其中 VOPC 组 98/107(91.6%)和 OPC 组 83/102(81.4%)的患者成功联系上。OPC 组仅有 6 名患者和 VOPC 组 10 名患者报告持续存在问题。进一步随访显示,82 名 VOPC 患者中有 78 名(95%)对他们的整体体验非常满意,而 61 名 OPC 患者中有 34 名(56%)(p<0.001)。两个队列中有相当大比例的患者-VOPC 组 68/82(83%)和 OPC 组 41/61(67%)(p=0.029)-更喜欢 VOPC 预约作为他们未来的随访选择。
大多数从外科服务中出院的患者可以通过虚拟诊所得到更好的随访,相当一部分患者报告对这种服务的偏好和更高的满意度。