Exploring Patient and Staff Experiences of Video Consultations During COVID-19 in an English Outpatient Care Setting: Secondary Data Analysis of Routinely Collected Feedback Data

Abstract

Abstract Background: Video consultations (VCs) were rapidly implemented in response to COVID-19, despite modest progress prior to the pandemic. Objectives: 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%), except for those aged 71+ (n=23/58, 39.7%), with ease of joining VCs negatively associated with age (P<.001). Despite more difficulties joining, older people 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). Patient satisfaction with communication was positively associated with technical performance satisfaction (P<.001). Most staff (89.8%) reported positive (n=185, 35.5%), or very positive (n=281, 54.3%) experiences of joining and managing a VC. 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 had 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 a new digital service. Feedback helped the Trust improve the VC service, challenge clinician held assumptions about patient experience and inform future use of VCs. The feedback has focussed 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.