Parkes Rebekah J, Palmer Joanne, Wingham Jennifer, Williams Dan H
Orthopaedic Department, Royal Cornwall Hospitals NHS Trust, Truro, UK.
Academic Vascular Surgical Department, Hull Royal Infirmary Postgraduate Medical Education Centre, Hull, UK.
BMJ Open Qual. 2019 Mar 1;8(1):e000502. doi: 10.1136/bmjoq-2018-000502. eCollection 2019.
To evaluate the acceptability to key stake holders of a newly introduced virtual clinic follow-up pathway for hip and knee joint replacement.
A service evaluation comprising a questionnaire sent electronically to 115 patients and interviews with 10 individuals.
A newly introduced virtual clinic follow-up pathway for hip and knee replacement patients in a district general hospital.
The electronic questionnaire was distributed to all patients treated under the virtual clinic service over a 5-month period (n=115). Purposive sampling from volunteers among respondents, leading to semi-structured interviews with eight patients. Two orthopaedic consultants were also interviewed.
Consultant review of web-based patient reported outcome measures and digital radiographs, with feedback to patients via letter, replacing face-to-face outpatient appointments for the follow-up of hip and knee joint replacement.
The response rate to the questionnaire was 40%. 44% indicated they would prefer a virtual appointment over a face-to-face consultation in future. The most common word in the free text comments was 'good' (n=107).Seven main themes were identified from the patient interviews: patient understanding and expectations, patient confidence, patient voice, managing deterioration of condition, patient benefit, patient satisfaction using technology and navigating the website.Two main themes were identified from the staff interviews: the adapting patient pathway and project management.Combined analysis elucidated that patients who were doing well liked the 'click and go' approach but those with problems were concerned about how to report these and were therefore less satisfied.
The virtual clinic process appears to be well accepted by both patients and clinicians. However, appropriate patient selection and clear pathways of communication to address patient concerns are pivotal to success.
评估新引入的髋关节和膝关节置换虚拟诊所随访路径对关键利益相关者的可接受性。
一项服务评估，包括以电子方式向115名患者发送问卷以及对10人进行访谈。
一家地区综合医院为髋关节和膝关节置换患者新引入的虚拟诊所随访路径。
在5个月的时间内，向所有接受虚拟诊所服务治疗的患者发放电子问卷（n = 115）。从受访者中的志愿者中进行目的抽样，对8名患者进行半结构化访谈。还对两名骨科顾问进行了访谈。
顾问对基于网络的患者报告结局指标和数字X光片进行审查，并通过信件向患者反馈，取代髋关节和膝关节置换随访的面对面门诊预约。
问卷回复率为40%。44%的人表示他们未来更倾向于虚拟预约而非面对面咨询。自由文本评论中最常见的词是“好”（n = 107）。从患者访谈中确定了七个主要主题：患者理解与期望、患者信心、患者声音、病情恶化管理、患者受益、使用技术的患者满意度以及网站导航。从员工访谈中确定了两个主要主题：调整患者路径和项目管理。综合分析表明，情况良好的患者喜欢“点击即走”的方式，但有问题的患者担心如何报告这些问题，因此满意度较低。
虚拟诊所流程似乎得到了患者和临床医生的良好接受。然而，合适的患者选择以及明确的沟通路径以解决患者担忧是成功的关键。
