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Restarting the MDT in Virtual Clinics

by Gary McCall | 7 months ago | in Rheumatology
Horizon 2

Since 2015, Rheumatology patients in our trust have had access to same day review by specialist physiotherapists within MDT clinics.  The MDT clinic was initially lost during the Covid pandemic as clinics changed to virtual format and each clinician sent out a separate appointment to the patient. 

This involved the necessity for the rheumatology patient to be referred to the physiotherapy department, which in turn led to an increased administrative burden on the service.  It also disrupted the patient journey as they were required to schedule a second virtual appointment for another day.

As of June we plan to start running MDT telephone / video clinics where the patients can be transferred over to the rheumatology specialist physiotherapist for virtual review within the same session as seeing another member of the MDT.  Patients will complete an anonymous feedback questionnaire about their MDT appointment.

What is needed to sustain the change?

Although this has so far only looked at parts of the MDT, if successful then investment is required to ensure physical infrastructure (IT / telecoms) are in place to allow clinics to run smoothly for all clinicians from team. 

Data to support the use of the virtual clinics being as effective as face to face reviews for patients using them (although we are aware that not all patients can be assessed treated remotely).

Access to good quality electronic patient information.  Early use of telephone clinics highlighted patients requesting information sent to them electronically and sometimes preferred in video format.

What is your region?

North West

edited on Jul 13, 2020 by Kyle Beacham
Gary McCall

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Elizabeth MacPhie 7 months ago

Hi Gary
Thanks for sharing this
We're giving some thought to whether we can have joint OT and physio virtual appointments for newly diagnosed IA patients where appropriate

What resources do you use for patients for advice about exercises, our physios send out exercise sheets and guidance using PhysioTools

Lizzy MacPhie

Reply 0

Gary McCall 7 months ago

Hi Lizzy

Joint OT and physio virtual appointments sound interesting.

We also have access to physio tools and use it on occasions. There are a lot of MFT created exercise video clips on youtube that we signpost patients to and have collected links to a lot of national organisations information (versus arthritis, Chartered society of physiotherapy, NASS etc).

We currently have ongoing projects developing patient information leaflets within the physio department for all MSK conditions. There have been occasional times when we don’t have a pre made set of exercises or advice we want to give (this tends to be for the extreme lower or higher level patients) but these gaps are slowly being filled.

So far the majority of people have been happy to take information on email (I think only one person has requested a paper copy).
BW
Gary

Reply 0

Carol McCrum 7 months ago

Hi Gary
Really helpful post- finding suitable youtube exercise clips can be challanging- would you be happy to share links of any you have found useful ?
Thank you

Reply 0

Gary McCall 7 months ago

Hi Carol

Thanks for the question. I agree that good videos are difficult to find and frequently I find a good section of a video that is then made unusable by extra information or advertising pinned onto it.

If you search on youtube for 'MFT Physio' then that should bring up a list of our in house created videos that are a good start.
BW
Gary

Reply 0

Kate Southall 7 months ago

Hi Gary
I am really interested to know what platform you are using to do this and the practicalities of perhaps not having a clinician available at that given moment that their expertise is required.
Do patients sit in a virtual waiting room in this instance or do you reschedule? Do you run to such a schedule that you can avoid overlap?

Reply 0

Gary McCall 7 months ago

Hi Kate

We are due to start the virtual MDT next week so can answer more fully then. The first week has been set up on telephone only, but should move to video link via ‘MS Teams’ soon.

For the first week the system is that I (physio) have empty slots in my clinic list. If a patient is identified by another member of the MDT to require a virtual physio review then they e-mail me the details across and I call the patient back. As we move across to ‘Teams’ I understand there is a virtual waiting room that the patient stays logged into and can be passed between clinicians.

In our face to face clinics pre covid, patients were happy to see physio the same day even if they had to wait a while. Hopefully that will still be the case if they have to wait a short time between telephone calls. We have a patient survey lined up to find out what the opinion is.
BW
gary

Reply 2

Kate Southall 7 months ago

I'd be really interested to know how you get on with the virtual waiting room. There are definite benefits to using MS Teams over other platforms

Reply 0

Greta McLachlan 7 months ago

Status labels added: Choice, Referral Pathway Redesign, Technology (Software/ Apps), Video Consulting, Virtual Consulting, Virtual MDT, Horizon 1

Reply 0

Greta McLachlan 7 months ago

Status labels added: Collaboration, Effective Team Working, Home Working / Remote Working, Investment In Technology, Patient Selection, Telephone Consulting, Horizon 2

Status label removed: Horizon 1

Reply 0

Greta McLachlan 7 months ago

The idea has been progressed to the next milestone.

Reply 0

Greta McLachlan 7 months ago

Status label added: Triage

Reply 0

Kyle Beacham 6 months ago

Status labels removed: Choice, Collaboration, Effective Team Working, Home Working / Remote Working, Investment In Technology, Patient Selection, Referral Pathway Redesign, Technology (Software/ Apps), Telephone Consulting, Triage, Video Consulting, Virtual Consulting, Virtual MDT

Reply 0

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