Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation

Objective To evaluate the acceptability to key stake holders of a newly introduced virtual clinic follow-up pathway for hip and knee joint replacement.Design A service evaluation comprising a questionnaire sent electronically to 115 patients and interviews with 10 individuals.Setting A newly introdu...

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Main Authors: Jennifer Wingham, Joanne Palmer, Rebekah J Parkes, Dan H Williams
Format: Article
Language:English
Published: BMJ Publishing Group 2019-01-01
Series:BMJ Open Quality
Online Access:https://bmjopenquality.bmj.com/content/8/1/e000502.full
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author Jennifer Wingham
Joanne Palmer
Rebekah J Parkes
Dan H Williams
author_facet Jennifer Wingham
Joanne Palmer
Rebekah J Parkes
Dan H Williams
author_sort Jennifer Wingham
collection DOAJ
description Objective To evaluate the acceptability to key stake holders of a newly introduced virtual clinic follow-up pathway for hip and knee joint replacement.Design A service evaluation comprising a questionnaire sent electronically to 115 patients and interviews with 10 individuals.Setting A newly introduced virtual clinic follow-up pathway for hip and knee replacement patients in a district general hospital.Participants The electronic questionnaire was distributed to all patients treated under the virtual clinic service over a 5-month period (n=115). Purposive sampling from volunteers among respondents, leading to semi-structured interviews with eight patients. Two orthopaedic consultants were also interviewed.Intervention Consultant review of web-based patient reported outcome measures and digital radiographs, with feedback to patients via letter, replacing face-to-face outpatient appointments for the follow-up of hip and knee joint replacement.Results The response rate to the questionnaire was 40%. 44% indicated they would prefer a virtual appointment over a face-to-face consultation in future. The most common word in the free text comments was ‘good’ (n=107).Seven main themes were identified from the patient interviews: patient understanding and expectations, patient confidence, patient voice, managing deterioration of condition, patient benefit, patient satisfaction using technology and navigating the website.Two main themes were identified from the staff interviews: the adapting patient pathway and project management.Combined analysis elucidated that patients who were doing well liked the ‘click and go’ approach but those with problems were concerned about how to report these and were therefore less satisfied.Conclusion The virtual clinic process appears to be well accepted by both patients and clinicians. However, appropriate patient selection and clear pathways of communication to address patient concerns are pivotal to success.
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spelling doaj-art-9ee74eac0a0946f1b35d82e74cc5c94f2025-08-20T02:48:30ZengBMJ Publishing GroupBMJ Open Quality2399-66412019-01-018110.1136/bmjoq-2018-000502Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluationJennifer Wingham0Joanne Palmer1Rebekah J Parkes2Dan H Williams32 Primary Care Research Group, University of Exeter, Exeter, UK2 Academic Vascular Surgical Department, Hull Royal Infirmary Postgraduate Medical Education Centre, Hull, UKTrauma & Orthopaedics, Derriford Hospital, Plymouth, UK1 Orthopaedic Department, Royal Cornwall Hospitals NHS Trust, Truro, UKObjective To evaluate the acceptability to key stake holders of a newly introduced virtual clinic follow-up pathway for hip and knee joint replacement.Design A service evaluation comprising a questionnaire sent electronically to 115 patients and interviews with 10 individuals.Setting A newly introduced virtual clinic follow-up pathway for hip and knee replacement patients in a district general hospital.Participants The electronic questionnaire was distributed to all patients treated under the virtual clinic service over a 5-month period (n=115). Purposive sampling from volunteers among respondents, leading to semi-structured interviews with eight patients. Two orthopaedic consultants were also interviewed.Intervention Consultant review of web-based patient reported outcome measures and digital radiographs, with feedback to patients via letter, replacing face-to-face outpatient appointments for the follow-up of hip and knee joint replacement.Results The response rate to the questionnaire was 40%. 44% indicated they would prefer a virtual appointment over a face-to-face consultation in future. The most common word in the free text comments was ‘good’ (n=107).Seven main themes were identified from the patient interviews: patient understanding and expectations, patient confidence, patient voice, managing deterioration of condition, patient benefit, patient satisfaction using technology and navigating the website.Two main themes were identified from the staff interviews: the adapting patient pathway and project management.Combined analysis elucidated that patients who were doing well liked the ‘click and go’ approach but those with problems were concerned about how to report these and were therefore less satisfied.Conclusion The virtual clinic process appears to be well accepted by both patients and clinicians. However, appropriate patient selection and clear pathways of communication to address patient concerns are pivotal to success.https://bmjopenquality.bmj.com/content/8/1/e000502.full
spellingShingle Jennifer Wingham
Joanne Palmer
Rebekah J Parkes
Dan H Williams
Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
BMJ Open Quality
title Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
title_full Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
title_fullStr Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
title_full_unstemmed Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
title_short Is virtual clinic follow-up of hip and knee joint replacement acceptable to patients and clinicians? A sequential mixed methods evaluation
title_sort is virtual clinic follow up of hip and knee joint replacement acceptable to patients and clinicians a sequential mixed methods evaluation
url https://bmjopenquality.bmj.com/content/8/1/e000502.full
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