Posted by: ayrshirehealth | November 11, 2015

Lights, Camera …. Clinic! by @ailsaweir1

Travel to France or Spain quicker

ArranSometimes I feel living in a remote area of Ayrshire with that added barrier or benefit depending on how you view it, of an 11 mile stretch of water allows us to look outside the box when it comes to providing more local patient friendly services.North Ayrshire

Patients who live on the island of Arran with a variety of cardiology conditions had to previously travel to Crosshouse Hospital in Kilmarnock on the mainland in order to have an appointment with their cardiologist, Dr Chong. This journey could also be particularly difficult for some of his patients not only because of the distance but due to the nature of their disease and chronic symptoms.

A typical journey for a patient to travel to Crosshouse by public transport could involve a 15-45 minute bus journey to the ferry followed by an hour’s ferry crossing. At Ardrossan, there is a 15 minute walk to the bus stop to then have another 90 minute bus journey to Kilmarnock– which could easily equate to a combined return travelling time of over six hours for a 15 minute appointment.

Many islanders joke that they could travel to France or Spain quicker!

A digital option

Arran War Memorial HospitalIn conjunction with Dr Chong, we developed a video conferencing cardiology clinic which is held at Arran War Memorial Hospital every 6-8 weeks and has been successfully running now for over 18 months.

Patients arrive at Arran War Memorial Hospital and are given a 40 minute appointment which includes a 15 minute pre consultation with the nurse, where we undertake baseline observations and measurements as well as discussing current medications. This also allows us time to give new patients information about the technology being used and that we will be sitting with the patient supporting them throughout the consultation. VC Room AWMH Another essential element to this is that we ask the patients what their expectations are of the clinic and talk through any points they would like to discuss. We have found this really valuable in gaining a greater insight into their concerns regards their condition and has the added benefit of making patients feel more supported in exploring their worries and asking questions during the main consultation.

The consultant is based at Crosshouse Hospital and the link is made between Arran War Memorial Hospital and Dr Chong via a portable video-conference system.
Having a portable unit allows us to have the clinic within the out-patient department and not restricted to the meeting room environments that other video-conferencing units are in. VC equipment AWMHFeedback from patients has been that this provides a much more familiar clinic environment to have their appointment.

Throughout the consultation, we will take detailed notes of the discussion and at the end of the appointment, we will reiterate the points raised in the conversation with Dr Chong to ensure that all information collated and decisions made are documented correctly and actioned as appropriate.

Patient Feedback

The benefits are more than just the avoidance of the journey. We have found that patients, who are in a local familiar setting such as Arran War Memorial Hospital, appear more relaxed and feel encouraged to open up more with the support of the nurse. Also the set up of the environment and the discussion is very patient-focused, therefore distractions are kept to a minimum, leading to a far more positive experience.

We have also found whilst undertaking these clinics that there is the added benefit that our staff on Arran have a greater awareness and knowledge of local resources such as AHP availability, local support groups etc and that we have GPs on site to facilitate medication changes promptly.Patient feedback

Patients were given the choice to have their next appointment at Crosshouse, if they felt uncomfortable or disliked the experience of the video-conference clinic.
To date no one has chosen this option. All patients have been given patient experience questionnaires to complete and currently this is sitting at 100% positive feedback. Comments have even indicated that the service felt more personal which I feel means we have definitely succeeded in providing a clinic environment that is conducive to the use of video-conferencing.

Challenges and explanations

DevelopmentTeamwork is fundamental when we use this form of patient communication and it is important that the staff on both sides of the video conference system feel comfortable in using the technology.

There was also some concern that the internet connection would not be sufficient or stable enough, and that would affect the quality of the video-consultation. It is explained to patients that we may need to re-dial if the connection is lost but there have been fewer problems than we had anticipated and re-connection is fast.

Looking ahead

The clinic has been very successful and now new projects and developments within the service are currently in discussion with the team to enhance our current provision.Looking ahead

I believe there are many more opportunities for other disciplines and specialities to use this invaluable method of delivering this type of out-patient service that has been so successful and positively received, for the benefit of other groups of patients in rural areas of Ayrshire.

This week’s blog was written by @ailsaweir1 (Ailsa Weir), Senior Charge Nurse, Arran War Memorial Hospital, Arran, North Ayrshire Health & Social Care Partnership (NHS Ayrshire & Arran).

 

 

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Responses

  1. Reblogged this on Chrys Muirhead .

  2. Fantastic account of what really can be done to tailor services to needs of the community. Really encouraged to hear of the success.

  3. Excellent example of innovation in service delivery that puts the needs and preferences of local people at the heart of design – looking forward to building on this and spreading the learning through our review of health and social care on Arran.

  4. Well done guys!

  5. What a great example of the changes that we can make to improve service delivery for our patients.

  6. What a great project. Use of technology to engage people and make the most of everyone’s precious time. Great blog, no where can we apply it across AYRSHIRE. Doesn’t have to be an island.


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