JMIR Publications

ABSTRACT

Background:

Video consultations (VCs) were rapidly implemented in response to COVID-19, despite modest progress prior to the pandemic.

Objective:

To explore staff and patient experiences of VCs implemented during COVID-19, and use feedback insights to support quality improvement and service development.

Methods:

Secondary data analysis was conducted on 955 (22.6%) patient responses and 521 (12.3%) staff responses routinely collected following a VC between June-July 2020 in a rural, aging and outpatient care setting at a single NHS Trust. Patient and staff feedback were summarised using descriptive statistics and inductive thematic analysis and presented to Trust stakeholders.

Results:

Most (93.2%) patients reported having Good (n=210, 22.0%), or Very Good (n=680, 71.2%) experience with VCs and felt listened to and understood (n=904, 94.7%). Most patients accessed their VC alone (n=806, 84.4%). Although, people aged 71+ needed help accessing VCs (n=23/58, 39.7%), and were more likely to find it difficult to join (P<.001), but despite this more were most likely to be satisfied with the technology (n=46/58, 79.3%). Both patients and staff generally felt patients needs had been met (n=860, 90.1%, n=453, 86.9% respectively), although staff appeared to overestimate patient dissatisfaction with VC outcome (P=.021). Patients (n=848, 88.8%) and staff (n=419, 80.5%) generally felt able to communicate everything they wanted, although patients were significantly more positive than staff (P<.001). Patients who were satisfied with communication were also likely to be satisfied with technical performance (P<.001). Most staff (89.8%) reported positive (n=185, 35.5%), or very positive (n=281, 54.3%) experiences of joining and managing VCs. Staff reported reductions in carbon footprint (n=380, 72.9%) and time (n=373, 71.6%). Most (n=880, 92.1%) patients would choose VCs again. Inductive thematic analysis of patient and staff responses identified three themes: i) barriers including technological difficulties, patient information and suitability concerns; ii) potential benefits including reduced stress, enhanced accessibility, cost and time savings; and iii) suggested improvements including trial calls, turning music off, photo uploads, expanding written character limit, supporting other internet browsers and shared interactive screen. This routine feedback, including evidence to suggest patients were more satisfied than clinicians anticipated, was presented to relevant Trust stakeholders allowing improved processes and supporting development of a business case to inform the Trust decision on continuing VCs beyond COVID-19 restrictions.

Conclusions:

Findings highlight the importance of regularly reviewing and responding to routine feedback following the implementation of new digital services. Feedback helped the Trust improve the VC service, challenge clinician assumptions about patient experience and inform future use. The feedback has focused improvement efforts on patient information, technological improvements such as blurred backgrounds and interactive white boards, and responding to the needs of patients with dementia, communication or cognitive impairment or lack of appropriate technology. Findings have implications for other health providers.