Introduction and assessment of video consultation in the pre-operative assessment clinic
Malins, Cathryn Murdoch, Henry
Malins, Cathryn
Murdoch, Henry
Glos Author
Date
2021-09-22
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Abstract
Following the emergence of COVID-19, the ability to assess patients in their own home, minimising unnecessary risk, whilst maintaining quality of service, is desirable. Published work on use of video in the pre-operative assessment pathway shows patient and provider satisfaction is high [1] and video consultations provide a safe and effective alternative to outpatient appointments for appropriate patients [2]. The Trust is participating in a national video consultation pilot study; the ‘Attend Anywhere (AA) Service’. Our objective was to implement and embed a video consultation service in the pre-operative assessment clinic (POAC). We aimed to establish and evaluate the service over a 4-month period.
Methods
The pre-existing AA platform and funding was used, equipment sourced, author trained and video calls trialled. A training programme for anaesthetists and nurses, and standard operating procedures and patient information were developed. Video calls were offered to all patients requiring anaesthetic consultation after completed POAC nurse appointments. Data were collected from patient and clinician surveys following each call.
Results
Between June and September 2020, 42 calls were booked which received clinician and patient feedback for 22 (52%) and 14 (33%), respectively. All patients felt able to communicate everything they wanted to clinicians. Ninety-three per cent (13/14) of patient responses rated the video call the same or better than previous face-to-face (F2F) appointments. All patients gave excellent feedback and would take up further virtual appointments if offered. Over 50% (8/14) of patients saved over 1 h and > 30 miles of travel. Sixty-eight per cent (15/22) of clinician responses were highly satisfied with the service, rating 4 or 5/5. Seventy-three per cent (16/22) rated the video call the same or better than F2F. The set-up was usually < 5 min (14/22). Ratings for technology correlated with clinicians rating for all other aspects of the survey including overall satisfaction. Comments highlighted issues with technology.
Discussion
We successfully established a new video consultation service in the POAC. Significant time, financial and lifestyle [C2] benefits were realised by patients. Successful interventions included identifying and training a nurse champion in the POAC to support anaesthetists and identification of appropriate patients. The number of calls and quality of service was limited by technology and patient preference; however, overall satisfaction was high, with clinicians and patients rating it the same or better than the F2F interaction.
References
1. Wong DT, Kamming D, Salenieks ME, Go K, Kohm C, Chung F. Pre-admission anesthesia consultation using telemedicine technology: a pilot study. Anesthesiology 2004; 100: 1605–7.
2. Shaw S, Wherton J, Vijayaraghavan S, et al. Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study. Health Services and Delivery Research, 2018; Jun: no. 6.21.
Citation
Malins, C., & Murdoch, H. (2021, September). Introduction and assessment of video consultation in the pre-operative assessment clinic. Anaesthesia. 76: pp. 22-22.
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