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Virtual outpatient clinic as an alternative to an actual clinic visit after surgical discharge: a randomised controlled trial
  1. Paul Healy1,
  2. Liam McCrone2,
  3. Roisin Tully2,
  4. Emer Flannery2,
  5. Aoife Flynn2,
  6. Caitriona Cahir3,
  7. Mayilone Arumugasamy1,
  8. Thomas Walsh1
  1. 1 Department of Surgery, Connolly Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2 Department of General Surgery, Connolly Hospital, Dublin, Ireland
  3. 3 Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
  1. Correspondence to Dr Paul Healy, Department of Surgery, Connolly Hospital, Royal College Of Surgeons in Ireland, Dublin 15, Ireland; drpaulhealy{at}gmail.com

Abstract

Background It is standard practice to review all patients following discharge at a follow-up clinic but demands on all health services outweigh resources and unnecessary review appointments may delay or deny access to patients with greater needs.

Aims This randomised trial aimed to establish whether a virtual outpatient clinic (VOPC) was an acceptable alternative to an actual outpatient clinic (OPC) attendance for a broad range of general surgical patients following a hospital admission.

Patients and methods All patients admitted under one general surgical service over the study period were assessed. If eligible for inclusion the rationale, randomisation and follow-up methods were explained, consent was sought and patients randomised to receive either a VOPC or an OPC appointment.

Results Two-hundred and nine patients consented to study inclusion, of which 98/107 (91.6%) in the VOPC group and 83/102 (81.4%) in the OPC group were successfully contacted. Only 6 patients in the OPC group and 10 in the VOPC group reported ongoing issues. A further follow-up indicated 78 of 82 (95%) VOPC patients were very happy with their overall experience compared with 34/61 (56%) in the actual OPC group (p<0.001). A significant proportion of both cohorts—68/82 (83%) in VOPC group and 41/61 (67%) in OPC group (p = 0.029)—preferred a VOPC appointment as their future follow-up of choice.

Conclusions The majority of patients discharged from a surgical service could be better followed up by a virtual clinic with a significant proportion of patients reporting a preference for and a greater satisfaction with such a service.

  • virtual out-patient clinic
  • surgical outpatient clinic
  • review
  • general surgery
  • randomised controlled trial
  • patient satisfaction

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Footnotes

  • Contributors PH drafted the proposal required for Ethical approval, was involved in data collection and analysis and drafted the main manuscript for submission. LMcC was involved in data collection, patient recruitment and data analysis. RT, EF and AF were involved in recruiting patients. CC performed statistical analysis of the data. RC provided advice to address some comments raised by the reviewers and this is acknowledged in the paper. MA was involved in drafting the manuscript. TW devised/proposed the project, supervised the staff involved and was involved in drafting the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Connolly Hospital, Blanchardstown, Dublin, Research and Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional unpublished data.

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