دورية أكاديمية
Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project
| العنوان: | Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project |
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| المؤلفون: | Udayaraj, Udaya, Ben-Shlomo, Yoav, Langdon, Maria, Anderson, Karen, Power, Albert, Dudley, Christopher, Evans, David, Burhouse, Anna |
| المصدر: | Udayaraj , U , Ben-Shlomo , Y , Langdon , M , Anderson , K , Power , A , Dudley , C , Evans , D & Burhouse , A 2019 , ' Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project ' , BMJ Open Quality , vol. 8 , no. 2 , e000427 , pp. e000427 . https://doi.org/10.1136/bmjoq-2018-000427Test |
| سنة النشر: | 2019 |
| المجموعة: | University of Bristol: Bristol Reserach |
| الوصف: | Kidney transplant patients in our regional centre travel long distances to attend routine hospital follow-up appointments. Patients incur travel costs and productivity losses as well as adverse environmental impacts. A significant proportion of these patients, who may not require physical examination, could potentially be managed through telephone consultations (tele-clinic). We adopted a Quality Improvement approach with iterative Plan–Do–Study–Act (PDSA) cycles to test the introduction of a tele-clinic service. We codesigned the service with patients and developed a prototype delivery model that we then tested over two PDSA improvement ramps containing multiple PDSA cycles to embed the model into routine service delivery. Nineteen tele-clinics were held involving 168 kidney transplant patients (202 tele-consultations). 2.9% of tele-clinic patients did not attend compared with 6.9% for face-to-face appointments. Improving both blood test quality and availability for the tele-clinic was a major focus of activity during the project. Blood test quality for tele-clinics improved from 25% to 90.9%. 97.9% of survey respondents were satisfied overall with their tele-clinic, and 96.9% of the patients would recommend this to other patients. The tele-clinic saved 3527 miles of motorised travel in total. This equates to a saving of 1035 kgCO2. There were no unplanned admissions within 30 days of the tele-clinic appointment. The service provided an immediate saving of £6060 for commissioners due to reduced tele-clinic tariff negotiated locally (£30 less than face-to-face tariff). The project has shown that tele-clinics for kidney transplant patients are deliverable and well received by patients with a positive environmental impact and modest financial savings. It has the potential to be rolled out to other renal centres if a national tele-clinic tariff can be negotiated, and an integrated, appropriately reimbursed community phlebotomy system can be developed to facilitate remote monitoring of patients. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://research-information.bris.ac.uk/en/publications/590e78c1-0ae9-4aed-96e8-22d7cecece4fTest |
| DOI: | 10.1136/bmjoq-2018-000427 |
| الإتاحة: | https://doi.org/10.1136/bmjoq-2018-000427Test https://hdl.handle.net/1983/590e78c1-0ae9-4aed-96e8-22d7cecece4fTest https://research-information.bris.ac.uk/en/publications/590e78c1-0ae9-4aed-96e8-22d7cecece4fTest https://research-information.bris.ac.uk/ws/files/199711504/e000427.full.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.27C8AEA5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/bmjoq-2018-000427 |
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