The Kidney Dietetics Service at Hull University Teaching Hospitals NHS Trust supports acute renal patients at Hull Royal Infirmary but the service also manages a more extensive cohort of outpatients through its renal satellite clinic. This clinic covers a wide geographical area – from Bridlington, Scunthorpe and Grimsby, with patients even spread out as far as Doncaster, Lincoln, Scarborough and York.
As the second Covid-19 lockdown went into force (July 2020), the team were no longer able to travel to see their patients and in order to stay in touch, required a new way of working to maintain communication and support. As well as introducing basic video and phone consultations, the service concluded that Patients Know Best (PKB) could offer a continuation in service delivery throughout the pandemic and also support their broader ambitions to go digital.
The benefits of digital engagement
"The transformation for our service has been brilliant"
Although the service had historically used Patient View – an online platform that formerly gave renal patients in the UK a view of their clinical data, many features were missing which could offer renal patients a more holistic experience.
The transition to Patient Know Best (PKB) came at the optimal time, helping to instantly bridge the gap that covid-19 had impeded on professionals and patients. Katherine Durrans, Clinical Lead Renal Dietitian, said: “The transformation for our service has been brilliant! We no longer have to rely on email to send patients their information and we can benefit from all the functions that PKB offers.”
Getting the best from PKB
As the driver for change, Katherine immediately saw the benefits that enabling patients to communicate with the service remotely presented. It not only improved how patient care was delivered but it also meant:
- less overall travel time for both patients and staff to the satellite clinics – this is better for patients and the environment
- more timely access to health information for patients and professionals
- faster response times to queries through secure messaging
- better use of clinic time by enabling patients to complete questionnaires in advance.
The service considered how to make the best use of the extensive features in PKB and during the initial pilot phase focussed on:
The service identified a range of resources to support patients at all stages of their care. These resources were added to the ‘Library’ feature so patients could access this information anytime. To begin with, the service added:
- recipe books
- YouTube tutorials
- patient leaflets
- links to charities
- links to local health App libraries.
2. Secure Messaging
The service began to use two-way messaging to enable patients and clinicians to continue communicating remotely. This meant:
- patients no longer had to leave answerphone messages and wait a couple of days for a response.
- the service was more responsive to a patients’ ‘real-time’ care needs.
Katherine highlighted: “One great benefit we have found by using the messaging section is that we have been able to respond more quickly in requesting GP prescriptions, reducing the delay often seen when waiting for prescriptions to be generated and when treatment can commence.”
4. Care Plans
By enabling an interactive two-way action plan of treatment, care plans were drawn up for:
- Bowel assessment
- Food diaries
- Nutritional screening
Getting patients signed up
“Getting patients signed up to PKB was really easy”, says Katherine. She added: “The feedback that I’m getting from patients is that they’re really enjoying using it, it’s easy to use and it’s a simple site for patients to navigate.”
Patients were registered with PKB during phone clinics with the process completed before the call ended. Patients were also signed up during video consultations which meant staff could share their screen to demonstrate how to find information and use the various features.
"The future is bright for us in Kidney Dietetics"
"PKB enables me to promote patient-centered care by using it as an educational tool as well as a clinical tool"
Despite starting with a small cohort of patients during the pilot phase, the Kidney Dietetics service is inviting a further 420 dialysis patients to register for PKB. “PKB enables me to promote patient-centered care by using it as an educational tool as well as a clinical tool”, said Katherine.
Patients are increasingly asked to update their care plans before their initial and follow up appointments, to enable more constructive dialogue with clear outcomes that are subsequently documented in their PKB health record. This allows patients, and anyone they choose to share their record with (i.e. family members, carers, GP, pharmacist etc) to refer back to this information to maintain integrated care and support at any time.
Since the implementation of PKB, the Kidney Dietetics service is better placed to support patients in the self-management of their renal condition. Patients can add their own measurements and symptoms to keep an eye on and the ability to contact the department for advice if they are concerned. Allowing for much better self care and supporting Patient Initiated Follow Ups.
“The future is bright for us in Kidney Dietetics”, said Katherine. “It’s proving to be something that we can’t do without – I definitely think that’s the case!”
More ways to benefit from PKB’s functionality
The team is continuing to look at more ways they can benefit from the functionality available in PKB and so they are now looking at using it to collect questionnaire data from patients using a new fibre supplement in order to gain data for ACBS prescribing approval upon governance approval.
Watch Katherine Dunbar talk about their service transformation with PKB at the recent Humber Coast and Vale Care Partnership Webinar.