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dc.contributor.authorIrving, Greg; orcid: 0000-0002-9471-3700
dc.contributor.authorLawson, David
dc.contributor.authorTinsley, Adele
dc.contributor.authorParr, Helen
dc.contributor.authorWhittaker, Cheryl
dc.contributor.authorJones, Hayley
dc.contributor.authorCox, Stephen
dc.date.accessioned2021-03-31T14:34:40Z
dc.date.available2021-03-31T14:34:40Z
dc.date.issued2021-03-28
dc.date.submitted2020-08-04
dc.identifierhttps://chesterrep.openrepository.com/bitstream/handle/10034/624416/bmjoq-2020-001081.xml?sequence=2
dc.identifierhttps://chesterrep.openrepository.com/bitstream/handle/10034/624416/bmjoq-2020-001081.pdf?sequence=3
dc.identifier.citationBMJ Open Quality, volume 10, issue 1, page e001081
dc.identifier.urihttp://hdl.handle.net/10034/624416
dc.descriptionFrom BMJ via Jisc Publications Router
dc.descriptionHistory: received 2020-08-04, rev-recd 2021-02-08, ppub 2021-03, accepted 2021-03-17, epub 2021-03-28
dc.descriptionPublication status: Published
dc.description.abstractThe COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being completed without obtaining objective recording of vital signs and face-to-face examination. Some regions have formed hot hubs to facilitate the review of suspected COVID-19 cases and keep their practice site ‘clean’ including the use of doorstep observations in avoiding the risk of face-to-face examination. To support the safe, effective and efficient remote assessment of suspected and confirmed patients with COVID-19, we established a doorstep assessment service to compliment telephone and video consultations. This allows physiological parameters such as temperature, pulse, blood pressure and oxygen saturation to be obtained to guide further triage. Quality improvement methods were used to integrate and optimise the doorstep assessment and measure the improvements made. The introduction of a doorstep assessment service increased the proportion of assessments for patients with suspected COVID-19 in routine care over weeks. At the same time we were able to dramatically reduce face-to-face assessment over a 6-week period by optimising through a range of measures including the introduction of a digital stethoscope. The majority of patients were managed by their own general practitioner following assessment supporting continuity of care. There were no adverse events during the period of observation; no staff absences related to COVID-19. Quality improvement methods have facilitated the successful integration of doorstep assessments into clinical care.
dc.languageen
dc.publisherBMJ Publishing Group
dc.rightsLicence for this article starting on 2021-03-28: http://creativecommons.org/licenses/by-nc/4.0/
dc.rightsEmbargo: ends 2021-03-28
dc.sourceeissn: 2399-6641
dc.subjectQuality improvement report
dc.subject1506
dc.subject2474
dc.subjectinfection control
dc.subjectPDSA
dc.subjectgeneral practice
dc.subjectquality improvement
dc.titleEvaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice
dc.typearticle
dc.date.updated2021-03-31T14:34:40Z
dc.date.accepted2021-03-17


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