Patient involvement via videoconference at the morbidity and mortality (M&M) meeting during COVID-19 (original) (raw)
Related papers
2020
Background: The Patient-Centered Team (PACT) focuses on the transitional phase between hospital and primary care for older patients in Northern Norway with complex and long-term needs. PACT emphasizes a person-centered care approach whereby the sharing of power and the patient's response to "What matters to you?" drive care decisions. However, during the COVID-19 pandemic, videoconferencing was the only option for assessing, planning, coordinating, and performing treatment and care. Objective: The aim of this study is to report the experience of the PACT multidisciplinary health care team in shifting rapidly from face-to-face care to using videoconferencing for clinical and collaborative services during the initial phase of the COVID-19 pandemic. This study explores how PACT managed to maintain person-centered care under these conditions. Methods: This case study takes a qualitative approach based on four semistructured focus group interviews carried out in May and June 2020 with 19 PACT members and leaders. Results: The case study illustrates that videoconferencing is a good solution for many persons with complex and long-term needs and generates new opportunities for interaction between patients and health care personnel. Persons with complex and long-term needs are a heterogeneous group, and for many patients with reduced cognitive capacity or hearing and vision impairment, the use of videoconferencing was challenging and required support from relatives or health care personnel. The study shows that using videoconferencing offered an opportunity to use health care personnel more efficiently, reduce travelling time for patients, and improve the information exchange between health care levels. This suggests that the integration of videoconferencing contributed to the preservation of the person-centered focus on care during the COVID-19 pandemic. There was an overall agreement in PACT that face-to-face care needed to be at the core of the person-centered care approach; the main use of videoconferencing was to support follow-up and coordination. Conclusions: The COVID-19 pandemic and the rapid adoption of digital care have generated a unique opportunity to continue developing a health service to both preserve and improve the person-centered care approach for persons with complex and long-term needs. This creates demand for overall agreements, including guidelines and procedures for how and when to use videoconferencing to supplement face-to-face treatment and care. Implementing videoconferencing in clinical practice generates a need for systematic training and familiarization with the equipment and technology as well as for an extensive support organization. Videoconferencing can then contribute to better preparing health care services for future scenarios.
Age and Ageing, 2021
Background the COVID-19 pandemic disproportionately affected care home residents’ and staffs’ access to health care and advice. Health and social care professionals adapted rapidly to using video consultation (videoconferencing) technology without guidance. We sought to identify enablers and barriers to their use in supporting care home residents and staff. Methods a scoping review of the evidence on remote consultations between healthcare services and care homes. Interviews with English health and social care professionals about their experiences during the pandemic. Findings were synthesised using the non-adoption, abandonment, scale-up, spread, sustainability framework. Results 18 papers were included in the review. Twelve interviews were completed. Documented enablers and barriers affecting the uptake and use of technology (e.g. reliable internet; reduced travelling) resonated with participants. Interviews demonstrated rapid, widespread technology adoption overcame barriers anti...
Agile Application of Video Telemedicine During the COVID 19 Pandemic
Original Research, 2020
Background The coronavirus disease 2019 (COVID-19) pandemic led to a need to introduce video telemedicine for outpatients as an emergency measure without widespread stakeholder consultation. The patient and clinician experience of video outpatient consultation during the peak of the pandemic was studied for acceptability and to gather recommendations to improve the service during continuing infection control measures. Methods Outpatient video telemedicine was introduced over a 14-day period including the provision of equipment, systems integration and stakeholder communication. Patient and clinician experience were measured between 15 April 2020 and 5 May 2020. Results A total of 43 patients and 79 clinicians provided feedback. Of the patients, 86% were above the age of 30 years, with the largest patient group aged 51-70 years. Patient experience was positive. All (100%) patients found joining the video consultation easy; 93% of them recommended to use it for future consultations. Clinician satisfaction was >90% with sound and video quality. Patients were less satisfied than clinicians in that they had communicated everything they wanted to (86% versus 95%). All (100%) patients thought that the video telemedicine solution met their needs, but 25% of clinicians believed that the patient experience of a video consultation was worse than a face-to-face clinic appointment. The three significant factors identified for introducing video consultations were successful IT, improved patient experience and digital healthcare records. Conclusions In the COVID-19 crisis, video telemedicine played a central role in outpatient consultations with excellent levels of success. With some differences in satisfaction level, clinicians significantly underestimate the level of patient satisfaction with outpatient video consultation.
BMJ Innovations
Following the outbreak of the novel SARS-CoV-2 (COVID-19), the World Health Organization made a number of recommendations regarding the utilisation of healthcare services. In general, there has been a reduction in elective healthcare services including outpatient clinics, diagnostic services and elective surgery. Inevitably these reductions for all but the most urgent clinical work will have a detrimental impact on patients, and alternative ways of working including the use of telemedicine may help to mitigate this. Similarly, electronic solutions may enable clinicians to maintain inter and intra-professional working in both clinical and academic settings. Implementation of electronic solutions to minimise direct patient contact will be new to many clinicians, and the sheer number of software solutions available and varying functionality may be overwhelming to anyone unfamiliar with ‘virtual communication’. In this article, we will aim to summarise the variety of electronic communic...
Review of Advanced Multidisciplinary Sciences, Engineering & Innovation, 2022
Telemedicine or telehealth technology is the practice of providing health care and exchanging health-related data across geographical boundaries. It is not a new or unique field of medicine. Telemedicine episodes can be classified by the following characteristics: (1) the nature of the interactions between patients and experts (live or prerecorded); and (2) the type of information transmitted (e.g. text, audio, video). By contrast, most telemedicine is now practised in developed countries. Additionally, interest in telemedicine is growing in developing countries as the public becomes more adept at utilising novel technologies in daily life. Evolving health care applications are reshaping when, where, and how patients and physicians interact. Thus, this review article aims to discuss the usage of telemedicine or telehealth technology for consultations between healthcare providers and patients during the COVID-19 pandemic.
JMIR Formative Research, 2021
Background The Patient-Centered Team (PACT) focuses on the transitional phase between hospital and primary care for older patients in Northern Norway with complex and long-term needs. PACT emphasizes a person-centered care approach whereby the sharing of power and the patient’s response to “What matters to you?” drive care decisions. However, during the COVID-19 pandemic, videoconferencing was the only option for assessing, planning, coordinating, and performing treatment and care. Objective The aim of this study is to report the experience of the PACT multidisciplinary health care team in shifting rapidly from face-to-face care to using videoconferencing for clinical and collaborative services during the initial phase of the COVID-19 pandemic. This study explores how PACT managed to maintain person-centered care under these conditions. Methods This case study takes a qualitative approach based on four semistructured focus group interviews carried out in May and June 2020 with 19 PA...
A Scoping Review of Changes to Patient-Doctor Communication During COVID-19
Research article, 2022
Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19 has prompted significant shifts in communication from in-room and face-to-face interactions to virtual consults. The impact of this pandemic-related change on patient-doctor communication goals, processes, attributes, and environment remains unclear. We undertook a scoping review involving the systematic search of seven academic databases for relevant articles published up to and including June 2021. In total, 47 articles were identified that met the inclusion criteria. We applied the patient-doctor communication framework to guide our deductive thematic analysis of articles included, sorting results from reported studies and position papers into themes and sub-themes. The theme of communication goals highlighted sub-themes related to patient safety, convenience, affordability, and satisfaction; preparation included sub-themes on technology interventions, workforce training, and digital literacy; participant attributes included compassion for doctors and rebuilding trust among patients; and communication process included issues related to telemedicine or video conferencing, challenges with diminished patient privacy, and distractions in the patient's home setting. Finally, the environment theme included insights into doctors' workload, isolation, and anxiety and how changes requiring increases in virtual consults iteratively altered confidence in care provision and communication with patients. Results of the scoping review provide important insights for strengthening virtual patient-doctor interactions, including target areas for training and professional development during and beyond the current pandemic.
Augmented video consultations in care homes during the COVID-19 pandemic: a qualitative study
BJGP open, 2022
Background: The COVID-19 pandemic necessitated an unprecedented implementation of remote consultations in UK primary care services. Specifically, older adults in care homes had a high need for infection prevention owing to their existing health conditions. GP practices in the East Midlands incorporated augmented video consultations (AVC) with the potential to support remote healthcare assessments for older adults at care homes. Aim: To explore GPs' and care home staff's experiences of the use of AVC as a mechanism to perform remote examinations of older adults in care homes. Design & setting: Qualitative interviews were conducted with GPs and care home staff in the East Midlands, UK, during May-August 2020. Method: A convenience sample of GPs (n = 5), nurses (n = 12), and senior healthcare assistants (n = 3) were recruited using a purposive approach. Data were collected through semi-structured telephone interviews and analysed using framework analysis. Results: Findings from participants indicated that AVC enabled real-time patient examinations to aid diagnosis and promoted person-centred care in meeting the needs of older adults. The participants also discussed the challenges of video consultations for patients with cognitive impairment and those receiving end-of-life care. Conclusion: AVCs show great potential in terms of GPs providing primary care services for care homes. However, healthcare staff must be involved in the development of the technology, and consideration should be given to the needs of older adults with cognitive impairment and those receiving end-of-life care. It is also vital that training is available to encourage confidence and competency in implementing the technology. How this fits in GP practices are experiencing challenges in accessing and providing care to an increasingly ageing population with complex medical needs, necessitating seeking new approaches to handle primary care demand in a flexible, efficient, and cost-effective way. The use of AVC could aid GPs to provide person-centred care to older adults who need medical attention in care homes, reducing the stress of the older adults travelling to GP surgeries. A robust infrastructure, with reliable access to software and internet-appropriate training for clinicians and the multidisciplinary team, is likely to facilitate the uptake and use of AVC in primary care, and meet the needs of an increasingly ageing population.