What is the challenge your project is going to address and how does it connect to your chosen theme?

There is demand from patients and staff to provide video clinics for those patients who have to travel far to UCLH. Earlier pilots of video clinics improved patient experience, even capturing patients who were otherwise lost to the system. However services struggled to sustain the remote clinic model due to the following challenges, which reflect those reported in the literature(1): duration of the pilot was not long enough to embed, inflexible model, no standard workflows were developed with IT team and no user input as existing technology was used.

With a new electronic health records system (EHRS) we are a unique position to use improvement methodology to work with staff and patients as a team to build on the pilots to design effective resources to support the spread video clinics across the trust.

(1) Greenhalgh T et al. Real-World Implementation of Video Outpatient Consultations at Macro, Meso, and Micro Levels: Mixed-Method Study. J Med Internet Res 2018;20(4):e150

What does your project aim to achieve?

The main beneficiaries are patients and staff. We aim to give patients more choice in how they would like to interact with healthcare, improve their experience and the quality of care. The objective is to produce resources that staff can use to successfully adopt and embed video clinics. It is part of a wider improvement project to roll-out video technology for remote clinics.

PDSA cycles will reveal the success criteria for sustainable video clinics, barriers to adoption and where they can add value. Patients and staff will use the cycles to design and test support tools that can be used by services to create the conditions for sustainable video clinic services that are easy to use and complement existing resources.

Success will be measured by patient experience and staff feedback, and the approval and use of the resources.

Other have shown the value of video clinics; this work would provide tools to support sustainability and spread for the technology.

How will the project be delivered?

The project will be delivered as an added part of a wider initiative involving the roll-out of video functionality and a trust-wide policy infrastructure for video clinics.  The additional funding will be for developing and delivering user experience design and testing of the support tools/resources for implementation.

The Director of Innovation, UCLH Improvement Lead and THF Improvement Science Fellow will provide direction.

The overall initiative includes key stakeholders such as patients, clinicians, administrators, IT team, the pilot programme manager, finance manager, and information governance lead. A sub-group will work on this project.

The core project team will facilitate the work of the group between the cycles and use trustwide PMO methods. The Improvement Science Fellow is also the EHRS patient safety lead and will provide clinical risk oversight. The Director of Innovation will provide business risk oversight.

What and how is your project going to share learning throughout?

On a basic level, we are planning to share any of the outputs developed to our established networks across patient and professional groups locally and nationally.  We also believe that there is immense value of transmitting other more tacit knowledge so would plan to engage others on a face-to-face basis by participating in discussions, be openly accepting requests to connect and opening our doors for visits e.g. by hosting learning days. These will be done in combination with other sharing learning events about the wider project.

We would also seek to use a diverse range of media to share the learning.

Communication methods:

Qualitative case studies
Uploading technical material such as the video clinic roll-out toolkit
Conference presentations
Informal publications e.g. blogs and other social media.
Publications in peer-reviewed journals

Networks:

Q Community
FutureNHS
UCL Partners
Other Epic sites as a UK Epic forerunner

UK Faculty of Clinical Informatics

Global Digital Exemplar forum