Evaluation of a Rapid Implementation of Telemedicine for Delivery of Obstetric Care During the COVID-19 Pandemic

Reid, Chinyere N.; Marshall, Jennifer; Fryer, Kimberly

doi:10.1101/2021.05.19.21257311

Cited by 2 publications

(4 citation statements)

References 9 publications

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“… 14 This qualitative evaluation uses the CFIR to explore the barriers and facilitators to implementing a COVID zone. 15 , 16 , 17 CFIR constructs guiding this evaluation included: intervention characteristics, outer setting, inner setting, characteristics of the individual and processes. Our methodology and findings below are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ, see Supporting Information: Appendix A ).…”

Section: Methodsmentioning

confidence: 99%

“…This analysis draws on data from a larger qualitative study examining the COVID care pathway 14 . This qualitative evaluation uses the CFIR to explore the barriers and facilitators to implementing a COVID zone 15–17 . CFIR constructs guiding this evaluation included: intervention characteristics, outer setting, inner setting, characteristics of the individual and processes.…”

Section: Methodsmentioning

confidence: 99%

“…13 Importantly, our findings add to the growing body of literature exploring the challenges implementing health interventions during a crisis like the COVID pandemic. [15][16][17][30][31][32] However, this study did not explore the implementation of specific rehabilitation therapies for patients recovering from COVID and additional research is needed to understand both the types of therapies and how best to implement them in this adapted context for patients recovering from acute infections as well as long COVID. 1,8,10,[41][42][43] The COVID zone was adapted in July 2021 once it was understood that cohorting patients recovering from COVID was no longer needed.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…The major strength of this study was the ability to rapidly evaluate the implementation of a COVID zone at the onset of the pandemic, using a robust theoretical framework 13 . Importantly, our findings add to the growing body of literature exploring the challenges implementing health interventions during a crisis like the COVID pandemic 15–17,30–32 . However, this study did not explore the implementation of specific rehabilitation therapies for patients recovering from COVID and additional research is needed to understand both the types of therapies and how best to implement them in this adapted context for patients recovering from acute infections as well as long COVID 1,8,10,41–43 …”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Implementation considerations for delivering inpatient COVID rehabilitation: A qualitative study

Sheppard

Szigeti

Simpson

et al. 2022

Evaluation Clinical Practice

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Rationale Patients recovering from significant COVID‐19 infections benefit from rehabilitation; however, aspects of rehabilitative care can be difficult to implement amidst COVID infection control measures. Aims and Objectives We used the Consolidated Framework for Implementation Research (CFIR) to evaluate the rapid implementation of a COVID zone in an in‐patient rehabilitation hospital at the onset of the first wave of the pandemic. Methods Semistructured interviews were conducted with health care providers ( n = 12) supporting the COVID zone, as well as with patients ( n = 10) who were discharged from the COVID zone and their family caregivers ( n = 5). The interviews explored the successes and challenges of working on the unit and the quality of care that was delivered to patients recovering from COVID. Results Rapid implementation of the COVID zone was supported by champions at the middle‐management level but challenged by a number of factors, including: conflicting expert opinions on best infection control practices (outer setting), limited flow of information from senior leaders to frontline staff (inner setting), lack of rehabilitation equipment and understanding of how to provide high quality rehabilitative care in this context (intervention characteristics), willingness and self‐efficacy of staff working in the COVID zone (individual characteristics) and lack of time to reflect on and assess effectiveness (process). Conclusions While there was an apparent need for rapid implementation of a COVID rehabilitation zone, senior leadership, middle management and frontline staff faced several challenges. Future evaluations should focus on how to adapt COVID rehabilitation services during fluctuating pandemic restrictions, and to account for rehabilitative needs of people recovering from significant COVID infections.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Implementation considerations for delivering inpatient COVID rehabilitation: A qualitative study

Sheppard

Szigeti

Simpson

et al. 2022

Evaluation Clinical Practice

View full text Add to dashboard Cite

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Optimising digital clinical consultations in maternity care: a realist review and implementation principles

Evans,

Clancy,

Evans

et al. 2024

BMJ Open

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ObjectivesThe COVID-19 pandemic has led to increased use of digital clinical consultations (phone or video calls) within UK maternity services. This project aimed to review the evidence on digital clinical consultations in maternity systems to illuminate how, for whom and in what contexts, they can be used to support safe, personalised and equitable care.DesignA realist synthesis, drawing on diverse sources of evidence (2010–present) from OECD countries, alongside insights from knowledge user groups (representing healthcare providers and service users).MethodsThe review used three analytical processes (induction, abduction and retroduction) within three iterative stages (development of initial programme theories; evidence retrieval and synthesis; validation and refinement of the programme theories).ResultsNinety-three evidence sources were included in the final synthesis. Fifteen programme theories were developed showing that digital clinical consultations involve different mechanisms operating across five key contexts: the organisation, healthcare providers, the clinical relationship, the reason for consultation and women. The review suggests that digital clinical consultations can be effective and acceptable to stakeholders if there is access to appropriate infrastructure/digital resources and if implementation is able to ensure personalisation, informed choice, professional autonomy and relationship-focused connections. The review found relatively less evidence in relation to safety and equity.ConclusionsDue to the complexity of maternity systems, there can be ‘no one-size fits all’ approach to digital clinical consultations. Nonetheless, the review distills four ‘CORE’ implementation principles: C—creating the right environment, infrastructure and support for staff; O—optimising consultations to be responsive, flexible and personalised to different needs and preferences; R—recognising the importance of access and inclusion; and E—enabling quality and safety through relationship-focused connections. Service innovation and research are needed to operationalise, explore and evaluate these principles, particularly in relation to safety and equity.PROSPERO registration numberCRD42021288702.

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Evaluation of a Rapid Implementation of Telemedicine for Delivery of Obstetric Care During the COVID-19 Pandemic

Cited by 2 publications

References 9 publications

Implementation considerations for delivering inpatient COVID rehabilitation: A qualitative study

Implementation considerations for delivering inpatient COVID rehabilitation: A qualitative study

Optimising digital clinical consultations in maternity care: a realist review and implementation principles

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