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Aims: The COVID-19 pandemic necessitated use of video consultations to provide continued patient care. It is not clear if video clinics are well received by patients, or if they are cost efficient. We evaluate The benefits of video consultation and review The impact on waiting times and cost implications to a trust. Method(s): 100 patients referred between January-December 2021 with gallstones were invited to complete a patient satisfaction questionnaire after initial clinic consultation. Patients were divided into three groups based on consultation type;face-to-face, telephone and video consultation (via The Attend Anywhere platform). Secondary outcome measures included time from referral to appointment, time to final outcome and cost implications. Result(s): 93 patients responded;33 video, 30 face-to-face and 30 telephone consultations. Of these patients 62% were female and 38% male with an average age of 51 (25-84). Average time from referral was 22 days in The video cohort, 22 in The telephone cohort and 32 for face-to-face appointments. Of The video cohort, 44% were booked for cholecystectomy from initial consultation and 56% sent for further investigation. The conversion rate from video to face-to-face consultation was zero. 50% of respondents stated face-to-face consultations as their preferred method of future consultation, 49% of patients opted for video and 1% preferred telephone consultation. 79% reported increased satisfaction due to convenience of consultation. Conclusion(s): This study demonstrates video consultations decrease costs and waiting times. Patient satisfaction is comparable to inperson visit. Specific referral criteria and patient selection is essential to maximise The benefits of video consultations.
RESUMO
The coronavirus disease 2019 (COVID-19) pandemic that emerged in early 2020 put unprecedented physical, mental, and emotional strain on the staff of health care organizations, who have been caring for a critically ill patient population for more than a year and a half. Amid the ongoing pandemic, health care workers have struggled to keep up with new information about the disease, while also coping with the anxiety associated with caring for affected patients. It has also been a continual challenge for nurse leaders to provide adequate support for staff members and keep them informed about frequently changing practices and protocols. In this article, nursing leaders at an academic medical center in Boston reflect on the initial COVID-19 patient surge, which occurred from March to June 2020, and identify key actions taken to provide clinical and emotional support to frontline staff who cared for these patients. Lessons learned in this period provide insight into the management of redeployed staff, use of emotional support and debriefing, and relationship between access to information and staff morale. The knowledge gained through these initial experiences has been a vital resource as health care workers continue to face challenges associated with the ongoing pandemic.
RESUMO
Study Objectives: Violence in the emergency department (ED) is a common and longstanding threat to staff. The COVID-19 pandemic brought unique challenges;however, it remains unclear what effect the pandemic had on violence in health care. The objective of this study was to identify the impact of the pandemic on workplace violence at an academic emergency department in the Midwest. Methods: The hospital referral region (HRR) COVID-19 case rate per 100,000 people was obtained from March through December 2020. Monthly incidents of ED violence were obtained from the Office of Security and included both physical assault and verbal threats where security officers were notified to respond. These incidents were combined with monthly reports of violent flags added to patient charts within the electronic medical record. Overlapping data from both sources were counted only once. Monthly ED patient volume was obtained to calculate a rate of violent incidents per 1,000 ED visits. Two anonymous surveys were sent to all multidisciplinary ED staff both pre/early-pandemic (April 2020) and mid/late-pandemic (December 2020) and surveyed respondents regarding the incidence of verbal abuse and physical assault experienced over the prior 6-months (November 2019-April 2020 and July 2020-December 2020). Chi-squared tests and Fisher’s exact tests were used for comparison. The study was deemed exempt by the Mayo Clinic Institutional Review Board. Results: There was a positive association between the HRR rate and rate of violent ED incidents (r = 0.24;Figure 1). There was also an increase in overall violent workplace incidents per ED volume during the pandemic compared to the months leading up to it. A total of 259 responses were received for the initial pre/early-pandemic survey and 259 responses received for the mid/late-pandemic survey. The reported level of safety perceived by staff remained the same, as did the overall percentage of respondents indicating any verbal abuse or physical assault in the prior 6-months. The frequency of verbal abuse experienced by staff did increase during the pandemic, with 6.2% of respondents pre/early-pandemic indicating verbal abuse by patients or their visitors every day or two, compared to 10.8% mid/late-pandemic (p =.029). Conclusion: Despite our findings of a positive association between the COVID-19 case rate and rate of violent ED incidents, the percentage of our survey respondents indicating verbal abuse or physical assault experienced in a 6-month time period remained unchanged between the pre/early-pandemic and mid/late-pandemic periods, as did staff perception of workplace safety. This difference in documented and self-reported/perceived violence may be attributable to staff prioritizing other personal safety concerns throughout the pandemic. This positive association could be due to significant fear and stress experienced by the general public, or worsening substance abuse or mental health state during the pandemic. [Formula presented]