Implementation of virtual consultations within an MSK Physiotherapy Paediatric service, in response to the Covid-19 pandemic –Therapists experience/feedback

Abstract

Keyword: Service improvement Purpose: To review the physiotherapist's experience/feedback of virtual consultations implemented due Covid-19, between the months of April 2020 and May 2020, by the paediatric MSK physiotherapy team at Southampton University Hospital NHS Foundation Trust. The data will also identify conditions/diagnoses that the therapists felt were most appropriate for virtual consultations. Methods: Therapists were asked to record on a database, between April 2020 and end of May 2020, the outcome of the appointments including:•If a NP or FU or consultation•If the therapist felt that a full assessment had been achieved•Opinions of the Pros and cons of virtual consultations•Conditions they felt responded well to video consults and those that did not. This data has been collated and outcomes presented. Recommendations have then been made. Results: A total of 148 treatment sessions were recorded on the data base. Of these:•63 – NP appointments•85 – FU appointments. Was a full assessment achieved:•26% – felt to have been able to provide a full assessment•64% – partially achieved with some components of the assessment and treatment lacking•10% – not appropriate for a virtual consultation. Pros and cons documented by therapists included:- Pros:•Save on travel time for patient•More time to ask questions in own home•Families cannot forget to bring equipment to appointment•Prevents missing school time•Assessment and treatment can be quicker•Patient was more compliant with assessment in their own environment Cons:•Video quality can be poor•Technical difficulties with connection•Security•Unable to build a rapport as easily•Lack of space for assessment•Lack of equipment•Unable to give hands on treatment•Unable to observe subtle patient behaviours and body language•Parents with busy /noisy household – lack of concentration and leaving the room Patients appropriate for video consultations-Hypermobility-mobility assessment/progression-brace check/change-exercise programme review/progression in between F2F-straightforward assessments/treatment techniques-straight forward post op ROM/function/mobility progression Patients not appropriate for video consultations-JIA- initial/symptom flare-back pain-treatment sessions-return to sport testing-complex pain-CAMHS assessment-guidance/support withy decisions about surgery-CP (neuro/ortho) – hip patients-TMJ-Myofascial release-stress incontinence-children under 5-autistic children-language barriers Conclusion(s): This review of data shows that therapy staff feels that virtual consultations do have a place within our physiotherapy practice. We have managed to highlight conditions that respond well to virtual session and those that do not. This list has enabled us to change/evolve our practice and continue to provide virtual clinics for appropriate patients and those that respond well to virtual sessions. Further work does need to be looked into regarding patient satisfaction and preference so we can then implement these changes within our service according to patient need. Impact: Once lockdown has ended we will continue to provide virtual clinics for appropriate patients. Further work does need to be looked into regarding patient satisfaction and preference so we can then implement theses changes within our service according to patient need. Funding acknowledgements: Not funded.