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Introduction
Mr. Duffy, a consultant at Harrogate & District NHS Foundation Trust (HDFT), is transforming post-operative follow-up care by utilising PKB messaging service by sending personalised video messages to his patients. Recognising that patients often struggle to retain information after day surgical procedures.
Welcomed by patients, this easy-to-replicate programme reduces unnecessary follow-up appointments and minimises pressure from unscheduled GP or emergency visits, freeing up valuable clinical time. Click the link to read the full case study on Transforming post-operative follow-up.
Why
Prevent patients from leaving the hospital without proper post-operative information about their operation and post-operative information and support. Reduce post-operative complications and follow-up appointments. Patients are leaving hospital without information about their operation and the routine post-operative advice.
What
PKB can support all aspects of peri-operative pathways with our messaging, questionnaire, and care plan features. These features, alongside clinical data sent to a patient's PKB record, provide clinicians with a secure communication tool to help reduce postoperative follow-ups by digitally engaging patients.
How
Patients are sent a message with a video from the consultant explaining what procedure was done and a detailed set of images from the procedure, better informing them of what happened in the operation and any relevant post-operative advice. This reduces the ward round after surgery for the doctor and provides information the patient can digest and read/watch when they get home.
Sharing videos and reports via PKB Messaging
A doctor sends a message to the patient straight after surgery
Operation notes and post-op advice given
Patients have access to these documents via any web-enabled device
Access as and when required
Access via NHS App events & messages jump off point
Example Message
Patient gets notification that there is a new message in their record
Current Problems
Teams experience a high level of face-to-face appointments
Teams want to give patients online resources
Patients travel long distances for short hospital appointments
With large waiting times, patient conditions can improve and deteriorate, meaning care and health needs change
Patients not receiving post-operative advice or surgical notes
Consultants have long post-operative ward rounds
PKB Solutions
PKB enables individualised care planning
A central, secure place for information and healthcare data to sit in the hands of the patient
Empowers patients to contribute to their own goals and care plans
Provides access to prevention and health promotion resources
Access to management advice, with patients being fully involved in their care through shared decision-making and self-management
Enhanced recovery care plans for elective recoverypathways
Supporting patients at home
Universal messaging, the ability for patients and teams to send messages in a timely, flexible way and all in the patient's record
PKB Features
There are key PKB features all orthopaedic services can use with their patients to support them while they wait, both preop and post-operatively. A list of them is below.
Messaging
Patients have access to message their healthcare team (saving time on the phone)
The Admin team can triage messages. Either resolving or passing onto another speciality team
Universal Messaging is the ability for patients to message clinical and non-clinical teams
Team-based messaging allows teams to automatically receive secure messages and questionnaires as a group rather than as individuals
Library
Central organisation library for advice, services and information
Disease and condition information with advice and resources
Treatment plans, for example, a rehab program with videos and advice a patient needs to watch and read each week
Rehabilitation information
Advice on Living well, including exercise, healthy eating, quitting smoking and alcohol recommendations
Details and links to National and local support groups and website
Professional alliance information
Treatment options for orthopaedic conditions and pain management
Care Plans
Care plan templates can be used to standardise the way that information is shared with a patient following their surgical procedure. Plans can educate patients on the procedure they have had, as well as providing follow up advice, guidance and support. Teams can create interactive procedure-specific care plans or generalised plans to support all patients who have undergone a procedure.
Care plans can include
Educational materials such as embedded images and videos
Generic resources, organisation-specific resources or tailored personal videos
PDFs/Documents
Resource library signposting patients towards useful resources and services
Prompts patients to track progress post-procedure
Include tailored symptom tracker and measurements (both manual and via integrated apps, devices and wearables).
Pre-emptive advice, including a Red/Amber/Green status, provides comprehensive support and what to do if they have any concerns
Allow patients to self-assess and self-manage their health and care
Care Plan Example
NHS APP
Patients are able to access care plans directly from within the NHS App via the care planning jump off point (specific to PKB), as well as via any web-enabled device.
Figure 2 - patient’s journey to access these care plans directly within the NHS App for the first time (including the second image showing the initial linkage of a patient’s NHS App and PKB account)
Questionnaires
Patients can initiate a questionnaire by clicking Start Consultation on their homepage or directly within the NHS App. Once completed, the questionnaire can be sent to a professional or team.
Teams using the questionnaire tool can ensure the outcome of clinical reviews is recorded and the patient has a copy. Teams can also identify patients suitable for virtual appointments or PIFU.
Questionnaire templates
Post operative/ enhance recovery program questionnaire
Add and View Data
Patients can automatically be added to the correct team through an integrated demographics feed, whereby these resources will be readily available without any manual intervention required by professionals. This demographics feed integration would take approximately 8 weeks to establish for a new organisation.
Patients can view hospitals and GP data where an integration with PKB has been set up
Data can include blood tests, x-ray reports, clinic and appointment letters, appointments and discharge summaries
Patients can add information themselves, including operations and conditions
Patients can track key measurements and add any symptoms related to their orthopaedic condition
Example Goal for using PKB
Reduce waiting list for the ………… team by December 2023 (... months post admin team go live) from (current waiting list times) to ( %) by validating all patients on the waiting for appointments by sending them a digital questionnaire through PKB instead of by post or not at all. Current waiting list rates are (%). …. months post-going live, the team compared the waiting list of patients with and without a PKB record. It is a local NHS priority to reduce waiting lists to save money.
Reduce the number of missed appointments (DNA) for the rheumatology team by Sept 2023 (12 months post team go live) from (current missed appointments) to ( %) by sending all appointment letters and appointment details into PKB instead of by post. Current missed appointment rates are (%). 12 months post-going live, the team compared missed appointment rates of patients with and without a PKB record. It is a local NHS priority to reduce missed appointments to save money.
Further Information
Example care plans can be found on PKB’s care planning toolkit, including examples for enhanced recovery after surgery, prehabilitation ahead of an orthopaedic procedure
Peri-operative care plans templates: examples of pre-op, consent, minor procedures and post-op templates created and used by teams
Consent Care Plan Templates: informed consent care plan examples
Shared decision tool care plan: PKB has converted these decision support tools into digital, editable and shareable care plans
Elective Recovery: how PKB can digitally support teams and patients at every stage of the pathway
Surgery teams: workflow and content
Mr Dave Duffy: explains how and why he uses PKB to send patients personalised videos post surgery.