Healthcare Improvement Project: An attempt to Increase Video Consultation (VC) use in a General Practice in the Scottish Highlands during the COVID-19 Pandemic

Introduction

To curtail the risk of COVID-19 exposure, guidance was issued to accelerate the introduction of digital consulting to Scottish practices not already utilising it. VC provided clinicians with visual information not provided during telephone consultations but while on placement in an NHS Highland practice it was clear that VC was not being used to its full potential. As such, this project aimed to increase the use of VC at the practice in question by 20% between December 2020 and April 2021.

Method

The primary outcome measure was the total number of VCs undertaken. Process measures included staff confidence, number of VCs declined by patients and the number of VCs with recorded issues in patient notes. The balancing measure was the number of clinicians using VC. The change implemented was a set of desktop instructions. It was hypothesised that this intervention would increase VC awareness, understanding and allow staff to concisely explain the process to patients. This resulting in an overall increased number of VCs. The instruction sheet was firstly introduced to clinical staff, adapted and then introduced to administration staff and finally to patients via social media.

Results

The aim was achieved short term during the first cycle of change from a median VC number of 7.5 to a total of 27 in three weeks. However, long term it cannot be claimed that the aim was achieved, as the median increased from 7.5 to 8.5 which is approximately a 13% increase.

Conclusion

The number of VCs in the second cycle of change was significantly lower that the first and this may be related to the difficulty in making behavioural changes long term. Additionally, further investigation of barriers to VC use is needed. Finally, this project and those similar may provide evidence needed for the Scottish government to accelerate the improvement of remote and rural Scotland’s broadband as VC is a provision which may increase healthcare accessibility.