Methodology
Conclusion
References
surgery software and clearly documented whether a remote or face-to-face consultation has taken place .
To ensure patient safety , safety netting had been a high priority with a low threshold to offer a faceto-face appointment if any concerns regarding the asthma control and / or their inhaler technique .
Electronic resources , such as Asthma UK ( 2021 ), for inhaler technique videos provided to patients .
Methodology
To establish an effective change in practice , the PDSA model of change ( NHS England & NHS Improvement , 2021 ) was used . The use of the cycle aided the improvement , ensuring safe care and a patient- centred approach with an aim to improve care and minimise any reluctance to change .
Internal and external factors which may affect the protocol were identified by using a SWOT analysis tool ( figure 1 ) as any barriers may have slowed down or stopped the protocol from succeeding ( De Silva , 2015 ).
Qualitative questionnaires were sent to clinical staff undertaking the remote reviews to gain an insight into the clinicians ’ personal views and experiences ( Holloway & Galvin , 2017 ). The asthma register was audited against previous years comparing how many face-to-face reviews were undertaken compared to remotely completed reviews .
As the PDSA model is cyclical in nature , it allows for any adjustments and improvements after analysing any results and the cycle is then repeated . However , as this initiative was new in its development any requirements and adaptations are not visible yet .
Conclusion
The use of technology and remote consultations are becoming the norm , however patient safety is paramount . Ensuring patient safety and safetynetting advice is embedded in all practitioners day-to-day practice ; ensuring patients are aware of any deterioration and symptoms not improving as they would expect and identifying when they need to seek further advice . This advice is however delivered differently for remote consultations and may be via a text message or an email with any differences in the patient not being seen directly in front of them .
Clinical protocols help to provide a quality and evidence-based service ; however , additional considerations are required when performed remotely to ensure the safety of patients and the clinician . The remote consultations were well received by patients and clinicians . Preliminary results indicated an uptake in routine asthma reviews due to remote access for patients who ordinarily struggled to attend the clinic due to factors such as work commitments , childcare , being housebound and those who experience mental health issues such as anxiety , which may have been exacerbated by the pandemic ( Khan , et al , 2020 ).
A repeat analysis using the PDSA cycle will take place to ensure continual improvement , with adaptations to include patient feedback questionnaires and audits to establish of how many patients received face-to-face consultations compared to remote for comparison to previous years .
References
Asthma UK . ( 2021 ). How to use your inhaler . London : Retrieved 25 September , 2021 , from www . asthma . org . uk / advice / inhaler-videos /
Beaney , T ., Salman , D ., Samee , T ., & Mak , V . ( 2020 ). Assessment and management of adults with asthma during the covid-19 pandemic . bmj , 369 .
British Thoracic Society . ( 2019 ). British Guideline on the management of asthma . A National clinical guideline . Retrieved August 17 , 2021 , from www . brit-thoracic . org . uk De Silva , D . ( 2015 ). What ’ s getting in the way ? barriers to improvement in the NHS . London : The Health Foundation