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dc.contributor.authorJones, Keira
dc.contributor.authorLennon, Emer
dc.contributor.authorMcCathie, Keighley
dc.contributor.authorMillar, Angela
dc.contributor.authorIsles, Chris
dc.contributor.authorMcFadyen, Angus
dc.contributor.authorShearer, Heather
dc.date.accessioned2022-06-07T11:30:17Z
dc.date.available2022-06-07T11:30:17Z
dc.date.issued2022-05-26
dc.identifier279880243
dc.identifierc96c90bc-af9e-4b69-a884-8a272f37f31b
dc.identifier85130979157
dc.identifier000802278500001
dc.identifier.citationJones , K , Lennon , E , McCathie , K , Millar , A , Isles , C , McFadyen , A & Shearer , H 2022 , ' Teledermatology to reduce face-to-face appointments in general practice during the COVID-19 pandemic : a quality improvement project ' , BMJ Open Quality , vol. 11 , no. 2 , e001789 . https://doi.org/10.1136/bmjoq-2021-001789en
dc.identifier.issn2399-6641
dc.identifier.otherJisc: 358161
dc.identifier.otherpublisher-id: bmjoq-2021-001789
dc.identifier.urihttps://hdl.handle.net/10023/25496
dc.description.abstractTeledermatology is an important subspecialty of telemedicine that continues to evolve with advances in telecommunication and mobile phone technology. A 19-week primary care quality improvement project collected baseline data and tested three change ideas, using the Model for Improvement method, with primary and secondary aims: to increase the weekly percentage of remote dermatological consultations with supporting images that were successfully concluded remotely to greater than 80% and to reduce the weekly percentage of dermatological face-to-face consultations to less than 50%. We hypothesised that by improving the quality of patient images and the confidence of reception staff in triaging skin complaints, there would be a decrease in the weekly number of face-to-face dermatological appointments, thereby decreasing the risk of COVID-19 transmission within the practice and community. Two change ideas focused on supporting patients to improve image quality by introducing ‘4 Key Instructions’ and a patient information leaflet (PIL). The third focused on increasing reception staff confidence in triaging skin complaints by introducing a triage pathway guidance tool. A total of 253 dermatological consultations were analysed: 170 of these were telephone consultations with 308 supporting images. Process measures showed clear improvements in the quality of images provided by patients which likely contributed to an increase in completed remote consultation. Our primary outcome measure was achieved. Our secondary outcome measure suggested that in the absence of high-quality images, it might not be possible to reduce dermatological face-to-face consultations much below 50% in primary care. Process measures showed clear improvements in the quality of images provided by patients which likely contributed to the increase in remote consultation. The implications of these findings for the theory of change are discussed.
dc.format.extent8
dc.format.extent1576885
dc.language.isoeng
dc.relation.ispartofBMJ Open Qualityen
dc.subjectQuality improvement reporten
dc.subjectHealthcare quality improvementen
dc.subjectControl charts/Run chartsen
dc.subjectCOVID-19en
dc.subjectPatient safetyen
dc.subjectRL Dermatologyen
dc.subjectNDASen
dc.subject.lccRLen
dc.titleTeledermatology to reduce face-to-face appointments in general practice during the COVID-19 pandemic : a quality improvement projecten
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Education Divisionen
dc.identifier.doi10.1136/bmjoq-2021-001789
dc.description.statusPeer revieweden
dc.identifier.urlhttps://bmjopenquality.bmj.com/content/11/2/e001789en


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