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Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
  1. Rebekah J Parkes1,
  2. Joanne Palmer2,
  3. Jennifer Wingham3,
  4. Dan H Williams1
  1. 1 Orthopaedic Department, Royal Cornwall Hospitals NHS Trust, Truro, UK
  2. 2 Academic Vascular Surgical Department, Hull Royal Infirmary Postgraduate Medical Education Centre, Hull, UK
  3. 3 Primary Care Research Group, Institute of Health Research, University of Exeter - Saint Lukes Campus, Exeter, UK
  1. Correspondence to Rebekah J Parkes; r.j.parkes{at}smd14.qmul.ac.uk

Abstract

Objective To evaluate the acceptability to key stake holders of a newly introduced virtual clinic follow-up pathway for hip and knee joint replacement.

Design A service evaluation comprising a questionnaire sent electronically to 115 patients and interviews with 10 individuals.

Setting A newly introduced virtual clinic follow-up pathway for hip and knee replacement patients in a district general hospital.

Participants 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.

Intervention 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.

Results 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.

Conclusion 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.

  • surgery
  • surveys
  • qualitative research
  • quality improvement
  • patient satisfaction

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors DHW clinically oversaw the study design and implementation of the new virtual clinic. JP and JW conducted the interviews and initial analysis. RJP undertook the wider analysis and wrote the paper with JP, JW and DHW all making contributions to the drafts and approving the final version.

  • Funding Shine funding from the Health Foundation. MCO provided their platform free of charge to the Trust.

  • Competing interests DHW is co-founder of MCO. There are no other competing interests.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Not required.