22 Evaluation and modification of medical handover using trainee feedback and technological advancements

Abstract

MethodsThe service model was rapidly implemented using successive PDSA cycles and NHS model for improvement methodology; undertaking rapid redeployment of resources to include clinicians and PPE to dedicated respiratory hubs. This enabled increasing numbers of COVID positive patients and those with respiratory infections to be streamed towards dedicated respiratory hubs. Using clinical SystmOne community modules, remote booking was enabled to allow practices to book directly to a respiratory triage gateway. Senior clinicians were able to triage patients virtually while selecting those requiring clinical face-to-face assessments. This maximised already meagre supplies of PPE within primary care and provided the most cost effective solution. Exposure of patients and staff within the community was also minimized. ResultsThe service was both clinically effective and highly valued by patients, staff and physicians in primary care. We were also able to study prescribing behaviour and delivered an admission avoidance service protecting secondary care from inappropriate demand induced by the COVID-19 pandemic. Conclusions We believe our methodology of implementation has proven the worth of integrated GP clinical systems and whole system integration via triage pathways that controlled patient flows towards the most clinically appropriate services during COVID-19 pandemic protecting secondary care services from being overwhelmed.