3.8 Article

Quality in Clinical Consultations: A Cross-Sectional Study

Journal

CLINICS AND PRACTICE
Volume 12, Issue 4, Pages 545-556

Publisher

MDPI
DOI: 10.3390/clinpract12040058

Keywords

clinical consultations; COVID-19 pandemic; quality; telemedicine

Funding

  1. Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) [WEISS 203145Z/16/Z, EP/P027938/1, EP/R004080/1]
  2. University College London (UCL) Biomedical Research Centre (BRC)
  3. National Institute of Health Research (NIHR)

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This study assessed the quality of outpatient consultations and found that the shift to telemedicine during the pandemic has negatively impacted consultation quality. High-quality consultations were associated with greater satisfaction and definitive consultation outcome decisions.
The coronavirus disease 2019 pandemic may have affected the quality of clinical consultations. The objective was to use 10 proposed quality indicator questions to assess outpatient consultation quality; to assess whether the recent shift to telemedicine during the pandemic has affected consultation quality; and to determine whether consultation quality is associated with satisfaction and consultation outcome. A cross-sectional study was used to survey clinicians and patients after outpatient consultations (1 February to 31 March 2021). The consultation quality score (CQS) was the sum of 'yes' responses to the survey questions. In total, 78% (538/690) of consultations conducted were assessed by a patient, clinician, or both. Patient survey response rate was 60% (415/690) and clinician 42% (291/690). Face-to-face consultations had a greater CQS than telephone (patients and clinicians < 0.001). A greater CQS was associated with higher overall satisfaction (clinicians log-odds: 0.77 +/- 0.52, p = 0.004; patients log-odds: 1.35 +/- 0.57, p < 0.001) and with definitive consultation outcomes (clinician log-odds: 0.44 +/- 0.36, p = 0.03). In conclusion, consultation quality is assessable; the shift to telemedicine has negatively impacted consultation quality; and high-quality consultations are associated with greater satisfaction and definitive consultation outcome decisions.

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