1. “seen very quickly from referral. understanding practitioner “
Satisfaction and evaluation of face to face vs telephone consultations for initial management referral to occupational health service A Pickles, C Leeds, K Darbyshire, E. Murphy
Introduction
A large proportion of Occupational Health consultations are undertaken by telephone. This has many benefits from reducing costs – actual clinic space is not required, reduces travel expense and time required for client – to improved flexibility for timings of appointments.
Telephone consultations also make remote working possible – further decreasing costs in terms of physical space and improving flexibility. Remote access working is already recognised as a useful tool in the business world and is increasingly utilized in the general practice and out of hours setting as a way of improving productivity.
Aims
To evaluate acceptability of telephone consultations versus face to face consultations for employees referred to Occupational Health by their managers.
To compare outcomes following telephone and face to face consultations
Methods
The target population was those NHS employees referred to occupational health in the period 1st November to 17th November In order to create a survey we have reviewed accepted patient satisfaction surveys from the Royal College’s/Faculty OM. We have used these as a base to create our own survey designed to be more specific to the occupational health consultation and to reflect that the data was collected retrospectively. The customer satisfaction questionnaire was ed once and subsequently at 4 weeks.
Outcome data was collected in addition to patient survey.
Results
Chart showing outcomes from initial consultations
Clinicians undertaking telephone consultations Clinicians undertaking face to face consultations o
Results cont.
Patients survey:
25 out of 27 employees were satisfied with all aspects of the consultation.
1 employee felt access to additional support was inadequate
1 employee encountered technical difficulties with telephone communication. i.e. phone kept cutting off.
Other Issues highlighted by patients in comments section of survey:
Timing of referrals (employee perspective – too early)
Appointment sent to work not always received due to being off sick
More notice desired before appointment
Additional Patient comments
Discussion
The number of cancelled, DNA or postponed appointments is likely to be an overestimate as in reality these appointments are often replaced with other clinical activity.
Of those where an intervention was made, more of those who were contacted by telephone were unfit. This is likely to be due to appropriate triage where telephone appointments are made when attendance is either unnecessary or inappropriate.
There appeared to be little difference in subjective reporting of client experience. One client reported technical difficulties with the telephone.
FOLLOWING TELEPHONE
FOLLOWING FACE TO FACE
“I felt like I was being listened to at every appointment and was offered excellent advice re my future and managing my expectations.”
“... Enough time to tell all my story in my own way - common sense approach to return to work plan ..”
“.. I was very pleased with the service and advice / support which was given...”
“..I did not particularly want to talk to anyone but the Dr was kind , compassionate and professional.”
“Good support from Dr, Nurses, Counsellor”
“punctual, friendly, competent. made me feel at ease”
“clinician gave me all of the options for return to work”
“seen very quickly from referral. understanding practitioner “
“Rapid appointment. Ownership of problem. Offered solutions to workplace”
“The Dr was very professional but friendly and provided good advice and help, and referred me for further help”
Of those where an intervention was made and recorded:
Face to face 17% unfit
Telephone 44% unfit
Conclusions
All clinicians in Occupational Health can consult face to face and via the telephone effectively.
Appropriate triage is needed to select suitability for each mode of consultation.
Further research could include client, manager and clinician perspectives and more detailed exploration of outcome measures.