Quality in Clinical Consultations: A Cross-Sectional Study

Clin Pract. 2022 Jul 14;12(4):545-556. doi: 10.3390/clinpract12040058.

Abstract

The coronavirus disease 2019 pandemic may have affected the quality of clinical consultations. The objective was to use 10 proposed quality indicator questions to assess outpatient consultation quality; to assess whether the recent shift to telemedicine during the pandemic has affected consultation quality; and to determine whether consultation quality is associated with satisfaction and consultation outcome. A cross-sectional study was used to survey clinicians and patients after outpatient consultations (1 February to 31 March 2021). The consultation quality score (CQS) was the sum of ‘yes’ responses to the survey questions. In total, 78% (538/690) of consultations conducted were assessed by a patient, clinician, or both. Patient survey response rate was 60% (415/690) and clinician 42% (291/690). Face-to-face consultations had a greater CQS than telephone (patients and clinicians < 0.001). A greater CQS was associated with higher overall satisfaction (clinicians log-odds: 0.77 ± 0.52, p = 0.004; patients log-odds: 1.35 ± 0.57, p < 0.001) and with definitive consultation outcomes (clinician log-odds: 0.44 ± 0.36, p = 0.03). In conclusion, consultation quality is assessable; the shift to telemedicine has negatively impacted consultation quality; and high-quality consultations are associated with greater satisfaction and definitive consultation outcome decisions.

Keywords: COVID-19 pandemic; clinical consultations; quality; telemedicine.

Grants and funding

HJM is supported by the Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) (grant numbers WEISS 203145Z/16/Z; EPSRC EP/P027938/1 and EP/R004080/1). We would like to thank them for funding the publication fees of this manuscript; however, no role was played in the design of the study; in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results. This research did not receive any other specific funding or grants. HJM is also supported by University College London (UCL) Biomedical Research Centre (BRC) and the National Institute of Health Research (NIHR).