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 

• Notifications about new messages

How to send a Message 

PKB Features

There are key 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

• Patient Reported Outcomes (PROMS)

• WLV questionnaire example

• Capturing Digital Outcome Measures

• 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.