Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice
COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Conseque...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-01-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/10/1/e001081.full |
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| author | Stephen Cox David Lawson Greg Irving Adele Tinsley Helen Parr Cheryl Whittaker Hayley Jones |
| author_facet | Stephen Cox David Lawson Greg Irving Adele Tinsley Helen Parr Cheryl Whittaker Hayley Jones |
| author_sort | Stephen Cox |
| collection | DOAJ |
| description | COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being completed without obtaining objective recording of vital signs and face-to-face examination. Some regions have formed hot hubs to facilitate the review of suspected COVID-19 cases and keep their practice site ‘clean’ including the use of doorstep observations in avoiding the risk of face-to-face examination. To support the safe, effective and efficient remote assessment of suspected and confirmed patients with COVID-19, we established a doorstep assessment service to compliment telephone and video consultations. This allows physiological parameters such as temperature, pulse, blood pressure and oxygen saturation to be obtained to guide further triage. Quality improvement methods were used to integrate and optimise the doorstep assessment and measure the improvements made. The introduction of a doorstep assessment service increased the proportion of assessments for patients with suspected COVID-19 in routine care over weeks. At the same time we were able to dramatically reduce face-to-face assessment over a 6-week period by optimising through a range of measures including the introduction of a digital stethoscope. The majority of patients were managed by their own general practitioner following assessment supporting continuity of care. There were no adverse events during the period of observation; no staff absences related to COVID-19. Quality improvement methods have facilitated the successful integration of doorstep assessments into clinical care. |
| format | Article |
| id | doaj-art-a62dee8324a844109ece1f1b8efcb166 |
| institution | OA Journals |
| issn | 2399-6641 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-a62dee8324a844109ece1f1b8efcb1662025-08-20T02:10:53ZengBMJ Publishing GroupBMJ Open Quality2399-66412021-01-0110110.1136/bmjoq-2020-001081Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practiceStephen Cox0David Lawson1Greg Irving2Adele Tinsley3Helen Parr4Cheryl Whittaker5Hayley Jones6University of Chester, Chester, Cheshire West and Chester, UKDepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA5 Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UKCentral Surgery Saint Helens, Saint Helens, UKHealth Research Institute, Edge HIll University, Ormskirk, UKSt Helens Rota, St Helens, UKMcCabe Centre for Law and Cancer, East Melbourne, Victoria, AustraliaCOVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being completed without obtaining objective recording of vital signs and face-to-face examination. Some regions have formed hot hubs to facilitate the review of suspected COVID-19 cases and keep their practice site ‘clean’ including the use of doorstep observations in avoiding the risk of face-to-face examination. To support the safe, effective and efficient remote assessment of suspected and confirmed patients with COVID-19, we established a doorstep assessment service to compliment telephone and video consultations. This allows physiological parameters such as temperature, pulse, blood pressure and oxygen saturation to be obtained to guide further triage. Quality improvement methods were used to integrate and optimise the doorstep assessment and measure the improvements made. The introduction of a doorstep assessment service increased the proportion of assessments for patients with suspected COVID-19 in routine care over weeks. At the same time we were able to dramatically reduce face-to-face assessment over a 6-week period by optimising through a range of measures including the introduction of a digital stethoscope. The majority of patients were managed by their own general practitioner following assessment supporting continuity of care. There were no adverse events during the period of observation; no staff absences related to COVID-19. Quality improvement methods have facilitated the successful integration of doorstep assessments into clinical care.https://bmjopenquality.bmj.com/content/10/1/e001081.full |
| spellingShingle | Stephen Cox David Lawson Greg Irving Adele Tinsley Helen Parr Cheryl Whittaker Hayley Jones Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice BMJ Open Quality |
| title | Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice |
| title_full | Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice |
| title_fullStr | Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice |
| title_full_unstemmed | Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice |
| title_short | Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice |
| title_sort | evaluation of a drop box doorstep assessment service to aid remote assessments for covid 19 in general practice |
| url | https://bmjopenquality.bmj.com/content/10/1/e001081.full |
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