If you’re used to doing things in a face to face setting, it can at first seem daunting to make the move to a virtual setting; particularly if you consider how much of our communication is non-verbal. The team at Interface Clinical Services, had to manage this exact challenge when we switched to delivering respiratory reviews remotely. We began conducting remote only COPD reviews in March and having delivered many reviews in that time, now have a team confident in doing them remotely.
So I've put together 10 top tips to help you conduct remote COPD reviews, as part of the Best Practice in Remote Consultations webinar delivered on behalf of GSK.
Video from the Best Practice in Remote Consultations webinar
Familiarise yourself with the patient before starting. A few things you might want to consider include checking the patient’s diagnosis and comorbidities which may influence the patient’s symptoms. Having a clearer picture of the patient helps when delivering the review.
2. Agenda setting
Outline and agree an agenda with the patient to help set a clear structure for the review. Setting the purpose and expectations for the call can allow for smooth running.
3. Open vs closed questions
Use open questions such as asking the patient how they feel, how they think they are doing or asking them to describe their symptom(s). This could potentially provide a fuller answer and give you more information about the patient. Using open questions and follow up with closed questions to help you zero in on specifics such as their symptoms and therapy.4.
4. Active listening
Sometimes active listening can feel more challenging through a remote review. Video consultations may be slightly easier as you have the advantage of sight. Using visuals cues such as head nodding will show the patient you are listening. When conducting reviews over the telephone, use verbal cues and summarise what the patient said back to them to signal you are listening.
5. Record keeping
Record keeping is an important part of any documentation. When it comes to remote reviews, document how and when the review took place, e.g. whether it was through telephone or video, who else was involved e.g. care givers or translators and document that consent was sought before allowing these individuals to take part in the review.
6. Time management
Sometimes reviews can go off topic and patients, particularly those who have been self-isolating or had limited social interactions, may wish to discuss issues unrelated to their respiratory care. In video reviews, you can offer visual cues such as holding up your hand to let the patient know you’d like to talk. In telephone reviews you can wait for a natural pause, and where this is tricky to do, use active listening techniques to let the patient know you have heard their comments however would like to hear more about a specific symptom or topic.
COPD reviews can cover a lot of information and it’s important to summarise this for patients, so they understand the key points. When summarising it’s a good idea to allow the patient to repeat back their key actions or next steps so you can be sure they understand the discussion.
8. Safety netting
Safety netting is important in any review however ensure the advice is relevant to the patient, anything which might be coming up for them or any interventions you might have made.
Hopefully by this point you will have covered everything you need to with the patient. To avoid any awkward silences at the end, provide a clear verbal statement such as ‘I’ve covered everything I need to for your COPD review, do you have any more questions?’. If they don’t thank them for their time and close the conversation. If they do, you may address their questions and then close again.
10. Taking breaks
Remote reviews can sometimes be challenging. You must listen very intently to patients, both in terms of what they’re saying and how they’re saying it. This can cause mental fatigue which may affect things such as decision making, so it’s important you take breaks throughout the day to recharge.
Want to learn more?
Hopefully the tips shared will help you feel more confident when delivering COPD reviews remotely. Check out the what does a remote COPD review involve article If you’d like to find out more about this topic.