A quality improvement pathway to rapidly increase telemedicine services in a gynecologic oncology clinic during the COVID-19 pandemic with patient satisfaction scores and environmental impact

• Main Authors: Rachel P Mojdehbakhsh, Stephen Rose, Megan Peterson, Laurel Rice, Ryan Spencer
• Format: Article
• Language: English
• Published: Elsevier 2021-05-01
• Series: Gynecologic Oncology Reports
• Subjects: Telemedicine; COVID-19 Pandemic; Gynecologic Oncology; Outpatient; Patient Satisfaction; Quality Improvement
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352578921000138

The primary goal was to convert 50% of all outpatient Gynecologic Oncology (GynOnc) encounters during the COVID-19 pandemic to telemedicine within one week. The secondary goal was to reach 100% documentation of telemedicine consent. The tertiary goal was to analyze patient satisfaction scores. An additional goal was to estimate CO2 emissions prevented from being produced.The period from 3/16/2020–4/15/2020 was targeted. The initial intervention involved transitioning surveillance visits. A second intervention, with nursing and advanced-practice-provider support, included transitioning additional visit types, and distributing a note template. The Telehealth Satisfaction Survey (TeSS) was administered to patients. Descriptive statistics and run charts were used to analyze and depict results.Within four weeks, there were 408 encounters; 217 were telemedicine (53.2%). Following the second intervention, 13 of 15 days (86.7%) reached the 50% telemedicine target and consent was documented in 96.6% of the telemedicine encounters. The TeSS had a 74.8% response-rate. Patients rated the following aspects of the telemedicine encounter as good or excellent: call quality (96.5%), personal comfort (92.9%), length-of-visit (94.7%), treatment explanation (93.8%), overall experience (88.5%). Moreover, 82.3% of patients would use telemedicine again. Additionally, 6.25 metric tons of CO2 emissions from travel were prevented from being produced.A GynOnc clinic can rapidly implement telemedicine systems. With multidisciplinary team planning and standardized note templates, transitioning 50% of encounters to telemedicine and achieving high rates of consent documentation were accomplished in four weeks. This increase in telemedicine represented a measurable decrease in the amount of CO2 emissions. Additionally, patients were overwhelmingly satisfied.