Patient satisfaction with a virtual multidisciplinary team balance clinic: a pilot study

Background/Aims: The COVID-19 pandemic led to many services being conducted remotely, including ear, nose and throat services. Although much in-person activity has now resumed, some services are still being provided remotely. This pilot study explored patients' satisfaction with the virtual multidisciplinary team balance clinics established at the authors' practice, looking at the feasibility of continuing this model of service delivery in the future. Methods: Self-administered questionnaires were posted to the 56 patients who had received a virtual consultation with the service between March and September 2020, of which 22 were returned. The questionnaire presented respondents with 14 items, with which they rated their agreement on a 6-point Likert scale. Correlations between the final item (which measured overall satisfaction) and the other items were analysed using Spearman's rho. Results: Overall, respondents were satisfied with the virtual consultations. Respondents either agreed or strongly agreed with 13 of the 14 items;the only exception was 'I obtained better access to healthcare services by use of telemedicine'. Most respondents were happy with the quality of communication and valued the time saved on travel, although one pointed out that this may not be an appropriate mode of service delivery for patients who are deaf. Conclusions: Virtual clinics can be an acceptable adjunct to traditional clinical consultations in an ear, nose and throat outpatient department for balance disorders and should be continued in future.

Mental health burden for NHS healthcare staff during the COVID-19 pandemic: First results of a longitudinal survey.

Background: The current investigation aimed to assess the mental health burden on healthcare workers during the early stages of the COVID-19 pandemic. Methods: A link to an online survey was sent to an estimate of 18,100 employees of Sheffield Teaching Hospitals NHS Foundation Trust (STH) who had access to email. The survey was completed between 2nd and June 12, 2020.1390 healthcare workers (medical, nursing, administrative and other professions) participated in the first survey. Data from a general population sample (n = 2025) was used for comparison. Severity of somatic symptoms was measured by the PHQ-15. Severity and probable diagnosis of depression, anxiety, and PTSD were measured by the PHQ-9, GAD-7, and ITQ. Linear and logistic regressions were performed to determine if population group predicted the severity of mental health outcomes, and probable diagnosis of depression, anxiety, and PTSD. Additionally, ANCOVAs were performed to compare mental health outcomes between occupational roles in HCWs. Analysis was performed using SPSS. Findings: Healthcare workers are more likely to experience greater severity of somatic symptoms, as well as severity and probable diagnosis of depression and anxiety, compared to the general population, but not increased traumatic stress symptoms. Scientific and technical, nursing and admin staff were more likely to experience worse mental health outcomes, compared to medical staff. Interpretation: The COVID-19 pandemic has led to increased mental health burden in some, but not all healthcare workers during the first acute phase of the pandemic. The findings from the current investigation provide valuable insights into which healthcare workers are particularly vulnerable to developing adverse mental health outcomes during and after a pandemic.

Patient satisfaction with a virtual multidisciplinary team balance clinic: a pilot study

Background/Aims: The COVID-19 pandemic led to many services being conducted remotely, including ear, nose and throat services. Although much in-person activity has now resumed, some services are still being provided remotely. This pilot study explored patients' satisfaction with the virtual multidisciplinary team balance clinics established at the authors' practice, looking at the feasibility of continuing this model of service delivery in the future. Methods: Self-administered questionnaires were posted to the 56 patients who had received a virtual consultation with the service between March and September 2020, of which 22 were returned. The questionnaire presented respondents with 14 items, with which they rated their agreement on a 6-point Likert scale. Correlations between the final item (which measured overall satisfaction) and the other items were analysed using Spearman's rho. Results: Overall, respondents were satisfied with the virtual consultations. Respondents either agreed or strongly agreed with 13 of the 14 items;the only exception was 'I obtained better access to healthcare services by use of telemedicine'. Most respondents were happy with the quality of communication and valued the time saved on travel, although one pointed out that this may not be an appropriate mode of service delivery for patients who are deaf. Conclusions: Virtual clinics can be an acceptable adjunct to traditional clinical consultations in an ear, nose and throat outpatient department for balance disorders and should be continued in future.

A multicentre retrospective cohort study on COVID-19-related physical interventions and adult hospital admissions for ENT infections.

PURPOSE: To report changes in adult hospital admission rates for acute ENT infections following the introduction of COVID-19-related physical interventions such as hand washing, use of face masks and social distancing of 2-m in the United Kingdom. METHODS: Retrospective cohort study comparing adult admissions with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess in the 1-year period after the introduction of COVID-related physical interventions (2020-2021) with a 1-year period before this (2019-2020) in three UK secondary care ENT departments. RESULTS: In total, there were significantly fewer admissions for ENT infections (n = 1073, 57.56%, p < 0.001; RR 2.36, 95% CI [2.17, 2.56]) in the 2020-2021 period than in the 2019-2020 period. There were significant reductions in admissions for tonsillitis (64.4%; p < 0.001), peritonsillar abscess (60.68%; p < 0.001), epiglottitis (66.67%; p < 0.001), glandular fever (38.79%; p = 0.001), acute otitis media (26.85%; p = 0.01) and retropharyngeal and/or parapharyngeal abscesses (45.45%; p = 0.04). CONCLUSION: Our study demonstrates a sizeable reduction in adult admissions for ENT infections since the introduction of COVID-19-related physical interventions. There is evidence to support the use of physical interventions in the prevention of viral transmission of respiratory disease. Preventing ENT infections requiring admission through simple physical interventions could be of great benefit to the quality of life of patients and economical benefit to healthcare systems.

Remote assessments for bone conduction hearing devices during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic had resulted in the suspension of many routine audiology services due to the risk of cross-infections in closed spaces. This has driven the need for exploring alternatives to conventional face-to-face consultations in the hospital outpatient setting. The aim of this study was to determine the efficacy of remote consultations and assessments for patients on the waiting list for consideration of bone conduction hearing devices (BCHDs), and whether this type of consultation could continue beyond the COVID-19 era. METHODS: This was a prospective cross-sectional study in a tertiary Neuro-otology Department. All new patients on the waiting list for assessment for BCHD as of 1 March 2020 were included. Patients' case notes were reviewed. All underwent a telephone consultation with an implant audiologist. If the patient wanted to go ahead with the remote trial, a BCHD sound processor on a headband would be mailed out and the patient would then have to use the device for two weeks and return the device after with their diary. RESULTS: There were 49 patients. The mean age was 55 (range 27-88, SD 16.3). Four did not proceed with the trial. All patients returned their devices to the department. Majority of patients (95.6%, n = 43), completed their diary. 75.6% wanted to proceed with surgery. All patients proceeding with surgery were happy with the remote assessment and would recommend this for the future. CONCLUSION: It is possible to satisfactorily assess appropriately screened patients for BCHDs remotely with a structured approach and explanation of process and expectations. It might be possible to consider this type of consultation as an option for assessing potential candidates for BCHDs beyond the COVID-19 era to reduce the number of hospital visits for patients.