Virtual outpatient clinic as an alternative to an actual clinic visit after surgical discharge: a randomised controlled trial. Issue 1 (5th October 2018)

• Record Type: Journal Article
• Authors: Healy, Paul; McCrone, Liam; Tully, Roisin; Flannery, Emer; Flynn, Aoife; Cahir, Caitriona; Arumugasamy, Mayilone; Walsh, Thomas
• Is Part Of: BMJ quality & safety. Volume 28:Issue 1(2019)
• Page Start: 24
• Page End: 31
• Publication Date: 2018-10-05
• Subjects: virtual out-patient clinic -- surgical outpatient clinic -- review -- general surgery -- randomised controlled trial -- patient satisfaction; Medical care -- Quality control -- Periodicals; Health facilities -- Risk management -- Periodicals; Medical errors -- Prevention -- Periodicals; 362.106805
• DOI: 10.1136/bmjqs-2018-008171
• Languages: English
• ISSNs: 2044-5415

Abstract

Abstract : Background: It is standard practice to review all patients following discharge at a follow-up clinic but demands on all health services outweigh resources and unnecessary review appointments may delay or deny access to patients with greater needs. Aims: This randomised trial aimed to establish whether a virtual outpatient clinic (VOPC) was an acceptable alternative to an actual outpatient clinic (OPC) attendance for a broad range of general surgical patients following a hospital admission. Patients and methods: All patients admitted under one general surgical service over the study period were assessed. If eligible for inclusion the rationale, randomisation and follow-up methods were explained, consent was sought and patients randomised to receive either a VOPC or an OPC appointment. Results: Two-hundred and nine patients consented to study inclusion, of which 98/107 (91.6%) in the VOPC group and 83/102 (81.4%) in the OPC group were successfully contacted. Only 6 patients in the OPC group and 10 in the VOPC group reported ongoing issues. A further follow-up indicated 78 of 82 (95%) VOPC patients were very happy with their overall experience compared with 34/61 (56%) in the actual OPC group (p<0.001). A significant proportion of both cohorts—68/82 (83%) in VOPC group and 41/61 (67%) in OPC group (p = 0.029)—preferred a VOPC appointment as their future follow-up of choice. Conclusions: The majority of patients discharged from a surgical service could be better followed up by a virtual clinic with a significant proportion of patients reporting a preference for and a greater satisfaction with such a service.