The impact of a virtual MSK physiotherapy service on patient satisfaction measures throughout 2020

ABSTRACT

Keywords Virtual Physiotherapy;Patient satisfaction;Management of change Purpose: Due to COVID-19, delivery of face-to-face musculoskeletal (MSK) physiotherapy had to evolve quickly to ensure safety of patients and staff. Nuffield Health adopted a fully virtual service that evolved into a hybrid service of virtual and face-to-face as the restrictions were lifted, representing a significant change in the delivery of MSK physiotherapy. It was deemed important to monitor the quality of the service throughout this time, so the aim of this project was to monitor patient satisfaction throughout the changes in physiotherapy delivery throughout 2020. Methods: Patient satisfaction was measured by Net Promotor Scores (NPS), satisfaction levels and text feedback from patients accessing the Nuffield Health physiotherapy service by means of an anonymised survey sent via email upon discharge. NPS is a measure of customer experience using the question “How likely are you to recommend Nuffield to a friend?” Subtracting the percentage of Detractors (0–6/10) from the percentage of Promoters (9–10/10) yields the Net Promoter Score, which can range from a low of −100 (if every customer is a Detractor) to a high of 100 (if every customer is a Promoter). Data from December 2019–February 2020 was used as a control group, March to May 2020 as a purely virtual group and then onwards to March 2021 as a hybrid group. All comments related to the virtual or hybrid delivery of physiotherapy were included in the analysis. Results: Control group NPS +67/patient satisfaction 91% Virtual NPS +62/patient satisfaction 91% (I) was concerned when the continuing physio went online. However, the experience was excellent… I had to stay at home and the video chats and exercises helped my recovery. Hybrid June 2020–August 2020 NPS +52/Satisfaction 86% September 2020–December 2020 NPS +61/Satisfaction 90% January 2021–March 2021 NPS +67/Satisfaction 92% My Physio was excellent and I liked the convenience of a mix of online through the App and face to face Great service, delivered remotely. Lots of advice, and the app is a great way of keeping track. Conclusion(s) There was only a small initial drop in NPS score for the full virtual service, possibly due to understanding this was essential to the health of the nation and was a temporary change in service. As the hybrid model was introduced, NPS and satisfaction did reduce, but then improved to pre-pandemic levels. This could be explained by the Managing transitions model (Bridges, 2009) with the initial drop representing the “endings” zone and gradual recovery being representative of both clinicians and patients moving through the “neutral” to the “new beginnings” zone. Comments indicate some patients feel virtual appointments are inferior to face-to-face, but others liked the convenience and the use of an app. Impact This service evaluation demonstrates level of patient satisfaction between a hybrid and fully face-to-face service are equal. This can be used as an ongoing model of care to provide choice to the individual and maximise efficiency of provision as the rehabilitation needs of the nation grow. Funding acknowledgements None.