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Adaptation of a stoma care pathway and use of telephone clinics during the pandemic: patient experience survey

13 January 2022
14 min read
Volume 31 · Issue 1

Abstract

With the arrival of the COVID-19 pandemic, outpatient clinics had to adjust and reduce the number of face-to-face appointments. The Cambridge stoma service has a recognised pathway of stoma care but needed to adjust this in line with government guidelines. The team took the opportunity to audit the current pathway and complete a patient experience survey to determine the future of the service and potential adaptations to the pathway in the future. Aim: To determine the need for adaptation and improvement of the standard stoma clinics pathway. Method: A survey was conducted using a postal questionnaire to all patients who attended stoma clinics between April and June 2020. Findings: 160 questionnaires were sent and 72 responses returned (45%). All elements of the virtual clinic were rated positive by more than 80% of respondents, with nearly 90% of them feeling that all their stoma care needs were met. When asked to indicate their preferred consultation methods (patients were allowed to choose more than one), face to face received 50 votes, telephone 32 votes and video clinic 5 votes. Conclusion: There is a need to adapt the standard clinic pathway to be able to offer standardised care but with flexibility to adjust to circumstances and patients' preferences.

Patient experience has been enshrined as a vital element of service improvement in England since the High Quality Care for All review in 2008 (Darzi, 2008). In March 2020, with the arrival of the COVID-19 pandemic, outpatient clinics had to adjust and reduce the number of face-to-face appointments.

Cambridge University Hospitals NHS Foundation Trust (CUH) has a number of Trust priorities and a Trust strategy for 2019-2020. In line with this the team endeavours to provide the highest quality of care and patient experiences within available resources, reducing variation and sustaining excellent outcomes. The stoma nurse service needed to adapt during the pandemic, so that patients had timely contact, support and care. One of the Trust strategies is ‘improving patient journeys’. The team felt a patient experience survey would determine whether they were maintaining the current standard of specialist nurse follow-up and identify where improvements could be made to the patient journey, flow and capacity brought about by the need for reduction in face-to-face appointments.

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