Questionnaire | Patient interviews | Consultant interviews | Summary |
Themes/Domains | Patient understanding and expectations | ||
|
|
| The questionnaire raised concerns that a significant minority were confused by the terminology, highlighting the need for consistency. While at interview patients were seen to have good understanding of the process. However, it was revealed that patients did not perceive the administrative and clinical team as a single unit. The addition of the consultant perspective revealed the virtual clinic rather than simply being a replacement for routine care was actually in some ways an additional service. |
Themes/Domains | Patient confidence | ||
|
|
| Patients need confidence that the processes are being managed and clinical oversight is in place. Interestingly it was the timely receipt of the clinic letter/report and the quality of its content that the interviews found as the chief determinant of the patient confidence in the process. It was therefore important that the majority of patients surveyed found the report clear. However, both aspects also showed that providing alternative contact options for reassurance are imperative. |
Themes/Domains | Patient voice | ||
|
|
| Patients were recruited by various methods: email, telephone call or by post. Some comments in the questionnaire hinted at frustration with communication. Exploring this further at interview it seemed that this could largely be addressed by offering a comments box or alternative method of contact so that patients could communicate their uncertainties. |
Themes/Domains | Managing deterioration of condition | ||
|
|
| Although some patients used the scores as an opportunity for self-management, there was a mislead expectation that if the scores were deteriorating over time this would be picked up by the consultant automatically (between virtual clinic appointments). It is important that patients are informed what action to take in the case of deterioration. |
Themes/Domains | Patient benefit | ||
|
|
| The questionnaire demonstrated the expected changes of patients choosing to use peripheral hospitals to have their radiographs. The process was reported as straight forward and both time and money saving. These findings were confirmed at interview. However, the it was only in the interviews that the benefit of self-management became evident. A further element was commented on by the consultants in that the follow-up would be available more long term than previously. |
Themes/Domains | Patient satisfaction | ||
|
|
| The questionnaire had unearthed quite diverse opinions about whether the virtual clinic was better or worse than having a face-to face consultation. Exploring this in the interviews it depended how well the process had worked for them and whether they were worried about their joint that caused this division. Interestingly some were relatively altruistic wanting the consultants to spend time with those in need. |
Themes/Domains | Using technology and navigating the website | ||
|
|
| Most patients were able to access the web from home and many found the virtual process easier than attending a traditional clinic. The patient interviews pointed to specific technical difficulties and were generally positive about the technology. However, the consultant interview highlighted the need for appropriate patient selection and perception that this pathway is suitable only so a specific sub population of those undergoing joint replacement. |
BOA, British Orthopaedic Association; MCO, My Clinical Outcomes; NHS, National Health Service; PROM, patient reported outcome measures.