ABSTRACT
ObjectiveTo explore Young Persons (YP) and healthcare professionals (HCP) experiences of virtual consultations (VC) and establish whether developmentally appropriate healthcare can be delivered virtually.MethodYP and HCP questionnaire surveys were designed and piloted. Electronic questionnaire links were sent by post, email or text message January–April 2021 to YP aged 13–25 years old, with predefined chronic gastrointestinal conditions, attending a gastroenterology/hepatology VC. HCP undertaking VC were invited to complete staff questionnaire. Results were anonymous and collated using Excel version 2302.ResultsFive UK hospital trusts participated, with 35 HCP responses. Of the 100 YP completing the survey 66% were female and 34% male aged between 13 years and 25 years (median: 18 years). 13% were new appointments and 87% follow ups, 29% were by video, 69% by phone and 2% gave no response. 80% of HCP spoke to YP directly but not privately (69%). 87% of YP and 88% HCP found VC useful. 83% of YP want VC again, although 20% preferred face to face. 43% of HCP required improved phone/internet connection. 77% of YP required hospital appointments for tests following VC.ConclusionsOverall respondents were satisfied with VC, finding them useful, convenient and time saving. Successful VC rely on appropriate patient selection and availability of reliable technology. Patient preference is key which may alter with time.
ABSTRACT
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) published recommendations regarding protection for the paediatric endoscopist during the coronavirus 2019 (COVID-19) pandemic.The aim of this survey was to investigate whether European paediatric gastroenterology centres applied the recommendations and how this extraordinary situation was handled by the different centres. RESULTS: Twelve paediatric European gastroenterology centres participated. Nine centres (75%) screened their patients for possible COVID-19 infection before the procedure, the same amount of hospitals changed their practice based on the ESPGHAN recommendations. Six-seven percentage of the centres reduced the staff in the endoscopy suite, 83% of the units used FFP2/3 masks and protective goggles during the procedure and 75% wore waterproof gowns. CONCLUSION: Uniform guidelines could not be applied by all European hospitals at a certain time point of the viral spread, as different regions of Europe were not only affected differently by COVID-19, but also had different access to personal protective equipment.
ABSTRACT
OFR-1 Table 1Key findings YP HCP VC strengths Saved time 84% Saved money 78% Reduced travel 25% Improved access to healthcare 81% Useful appointment 87% Would like VC again 83% More efficient & convenient Don’t miss education/work Safer during COVID Spoke to YP directly 80% Saw more patients 23% More free admin time 23% Convenient Don’t always need clinic room VC barriers Poor WIFI Need extra appointment for investigations/to collect prescriptions Communication easier face to face Less private Patient had to come to hospital for tests post VC 77% Unable to speak to YP privately 69% Unable to contact patient 48% Information technology (I.T) problems 29% Difficulty arranging investigations 23% Suggested improvements Improve I.T Use video not phone Prefer face to face Improve I.T 86% Have YP present for VC Ability to speak to YP alone Having results ready and easily accessible Improved pathways for requesting tests ConclusionsOverall respondents were satisfied with VC and felt they were useful, convenient and saved time.The surveys highlighted that improved I.T for both staff and patients is vital. In addition, improved processes for requesting investigations, prescriptions and accessing results would minimise admin time for staff and extra appointments for patients.Direct engagement and privacy with YP was reported to be more difficult with VC, which is an important consideration in developmentally appropriate transitional healthcare. Some YP felt more comfortable discussing personal or complex issues face to face with a HCP that they knew.It is important to recognise patient preference for face to face or virtual clinics and personalise care accordingly, acknowledging that this may alter with time and circumstance.Successful virtual consultations rely on appropriate patient selection and availability of reliable WIFI and IT. Patient preference is key and this may alter with time.
ABSTRACT
BACKGROUND: COVID-19 has impacted on healthcare provision. Anecdotally, investigations for children with inflammatory bowel disease (IBD) have been restricted, resulting in diagnosis with no histological confirmation and potential secondary morbidity. In this study, we detail practice across the UK to assess impact on services and document the impact of the pandemic. METHODS: For the month of April 2020, 20 tertiary paediatric IBD centres were invited to contribute data detailing: (1) diagnosis/management of suspected new patients with IBD; (2) facilities available; (3) ongoing management of IBD; and (4) direct impact of COVID-19 on patients with IBD. RESULTS: All centres contributed. Two centres retained routine endoscopy, with three unable to perform even urgent IBD endoscopy. 122 patients were diagnosed with IBD, and 53.3% (n=65) were presumed diagnoses and had not undergone endoscopy with histological confirmation. The most common induction was exclusive enteral nutrition (44.6%). No patients with a presumed rather than confirmed diagnosis were started on anti-tumour necrosis factor (TNF) therapy.Most IBD follow-up appointments were able to occur using phone/webcam or face to face. No biologics/immunomodulators were stopped. All centres were able to continue IBD surgery if required, with 14 procedures occurring across seven centres. CONCLUSIONS: Diagnostic IBD practice has been hugely impacted by COVID-19, with >50% of new diagnoses not having endoscopy. To date, therapy and review of known paediatric patients with IBD has continued. Planning and resourcing for recovery is crucial to minimise continued secondary morbidity.