Department of Palliative Medicine, Sir Michael Sobell House Hospice, Oxford, Oxfordshire, UK
Department of Palliative Medicine, Sir Michael Sobell House Hospice, Oxford, Oxfordshire, UK.
BMJ Support Palliat Care. 2020 Sep;10(3):271-275. doi: 10.1136/bmjspcare-2020-002326. Epub 2020 May 26.
During the Covid-19 pandemic, a strategy to minimise face-to-face (FtF) visits and limit viral spread is essential. Video consultations offer clinical assessment despite restricted movement of people.We undertook a rapid literature review to identify the highest currently available level of evidence to inform this major change in clinical practice. We present a narrative synthesis of the one international and one national guideline and two systematic reviews-all published within the last 18 months.The global evidence appears to support video consultations as an effective, accessible, acceptable and cost-effective method of service delivery. Organisations must ensure software is simple, effective, reliable and safe, with the highest level of security for confidentiality.Although video consultations cannot fully replace FtF, they can radically reduce the need for FtF and the risk of Covid-19 spread in our communities while maintaining high standards of care. For patient safety, it will be critical to follow the WHO guidance regarding: a standard operating procedure; clinical protocols for when video consultations can (and cannot) be used; policies to ensure equity of access in disadvantaged populations; adequate staff training; and administrative support to coordinate appointments.
在 COVID-19 大流行期间，必须采取策略尽量减少面对面（FtF）就诊次数并限制病毒传播。视频咨询可提供临床评估，尽管人员流动受到限制。我们进行了快速文献综述，以确定目前可获得的最高证据级别，为这一临床实践的重大改变提供信息。我们对一项国际和一项国家指南以及两项系统评价进行了叙述性综合，所有这些评价均在过去 18 个月内发表。全球证据似乎支持将视频咨询作为一种有效、可及、可接受且具有成本效益的服务提供方式。各组织必须确保软件简单、有效、可靠且安全，并具有最高级别的保密性。尽管视频咨询不能完全替代 FtF，但它可以大大减少 FtF 的需求和社区中 COVID-19 传播的风险，同时保持高标准的护理。为了患者安全，至关重要的是遵循世卫组织关于以下方面的指导：标准操作程序；视频咨询何时可以（和不能）使用的临床方案；确保弱势人群获得公平机会的政策；充分的员工培训；以及协调预约的行政支持。
