Patient, clinician and manager experience of the accelerated implementation of virtual consultations following Covid‐19

A qualitative study of preferences in a tertiary orthopaedic rehabilitation setting

Bibliographic Data

ID19506533
AuthorsAnthony Gilbert (0000-0003-2526-8057, Therapies Department Royal National Orthopaedic Hospital Stanmore UK, corresponding author), Jeremy Jones (0000-0003-0090-2867, Faculty of Environmental and Life Sciences, School of Health Sciences University of Southampton Southampton UK), Maria Stokes (0000-0002-4204-0890, Faculty of Environmental and Life Sciences, School of Health Sciences University of Southampton Southampton UK), C May (0000-0002-0451-2690, NIHR Applied Research Collaboration North Thames UK)
Year2022
Volume25
Issue2
Pages775-790
Publication date2022-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.13425
PMID35014124
OpenAlexW4206380803
LanguageEN
Citations received1
References cited32

AIM: To investigate the experiences of patients, clinicians and managers during the accelerated implementation of virtual consultations (VCs) due to COVID-19. To understand how patient preferences are constructed and organized. METHODS: Semi-structured interviews with patients, clinicians and managerial staff at a single specialist orthopaedic centre in the United Kingdom. The interview schedule and coding frame were based on Normalisation Process Theory. Interviews were conducted over the telephone or by video call. Abductive analysis of interview transcripts extended knowledge from previous research to identify, characterize and explain how patient preferences for VC were formed and arranged. RESULTS: Fifty-five participants were included (20 patients, 20 clinicians, 15 managers). Key mechanisms that contribute to the formation of patient preferences were identified. These were: (a) context for the consultation (normative expectations, relational expectations, congruence and potential); (b) the available alternatives and the implementation process (coherence, cognitive participation, collective action and reflexive monitoring). Patient preferences are mediated by the clinician and organisational preferences through the influence of the consultation context, available alternatives and the implementation process. CONCLUSIONS: This study reports the cumulative analysis of five empirical studies investigating patient preferences for VC before and during the COVID-19 pandemic as VC transitioned from an experimental clinic to a compulsory form of service delivery. This study has identified mechanisms that explain how preferences for VC come about and how these relate to organisational and clinician preferences. Since clinical pathways are shaped by interactions between patient, clinicians and organisational preferences, future service design must strike a balance between patient preferences and the preferences of clinicians and organisations. PATIENT AND PUBLIC CONTRIBUTION: The CONNECT Project Patient and Public Involvement (PPI) group provided guidance on the conduct and design of the research. This took place with remote meetings between the lead researcher and the chair of the PPI group during March and April 2020. Patient information documentation and the interview schedule were developed with the PPI group to ensure that these were accessible

Medical education · MEDLINE · Normative · Patient participation · Qualitative research · Reflexivity · Virtual patient · Applied Psychology · Healthcare Systems and Technology · Medicine · Nursing · Patient-Provider Communication in Healthcare · Psychology · Telemedicine and Telehealth Implementation

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