Rapid introduction of virtual consultation in a consultant-led antenatal clinic in a hospital setting to minimize exposure of pregnant women to COVID-19

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BMJ Open Qual. 2022 Jan;11(1):e001622. doi: 10.1136/bmjoq-2021-001622.

ABSTRACT

The global COVID-19 pandemic has dictated a rapid change in outpatient services within our London-based maternity hospital. Coupled with the long wait times in the consultant-led antenatal clinic, we sought to reduce hospital attendance and unnecessary contact with a clinically vulnerable patient population by reducing face-to-face consultations. Many specialties have already successfully implemented safe and efficient teleconferencing, enabling remote review while reducing the risks posed by face-to-face contact. A target of seeing at least 15% of women remotely has been set to reduce attendance at the consultant-led antenatal clinic. We have sought to reduce face-to-face waiting times to an average of 30 min. In March 2020, the clinics were pre-screened by the clinic consultant to carefully select suitable women for video or phone consultations. Clinic models have been changed, increasing appointment times from 5 to 25 minutes each. AccuRx software was tested and used to communicate appointment details and conduct the consultation. In-person clinic wait times and number of virtual consultations over a 3-month period were recorded, along with qualitative feedback from service users and staff through surveys and departmental meetings. Average wait times were reduced by 33% from 45 minutes to 30 minutes, and many benefits for service users were noted, including partner involvement, convenience of waiting for appointments at home and the removal of the child care requirement. However, the limitations of internet connectivity, the need for time to notify clinics, and the lack of a robust administrative system to notify women of their type of appointment were highlighted. Further work is needed in these areas to ensure the sustainability and improvement of this process for the future.

PMID:35027342 | DOI:10.1136/bmjoq-2021-001622

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