Patient safety measures for virtual consultations in primary care: a systematic review.

IF 6.5 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Tetiana Lunova, Katherine-Helen Hurndall, Ulrik Bak Kirk, Bryony Dean Franklin, Ara Darzi, Ana Luisa Neves
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引用次数: 0

Abstract

Objectives: With the growing adoption of virtual consultations in primary care, the need for tailored metrics to evaluate their safety became increasingly urgent. This systematic review seeks to identify and review existing safety measures that could be used for safety evaluation of virtual consultations in primary care.

Methods: This has been conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and followed a published protocol. A systematic literature search was performed in Ovid MEDLINE/PubMed, Embase and Cochrane Library databases from 2014 to 2024. Studies comparing virtual consultations with face-to-face consultations in the primary care setting were included. An inductive thematic analysis was performed to systematically extract and group the safety measures into overarching themes, with a narrative synthesis to summarise the results.

Results: A total of 47 studies (31 experimental and 16 observational studies) were included (n=2 223 697 patients). All studies assessed the safety of virtual versus face-to-face consultations via one or both of the following domains: (1) factors that influence the safety of virtual consultations and (2) tangible outcomes of virtual care safety. The former were categorised into provider-related, patient-related and system-related factors. Tangible outcomes were evident through three subthemes-adverse events, health outcomes and patient perception of safety.

Conclusions: This review provides a systematic synthesis of measures for the safety evaluation of virtual consultations. Further research into patient and physician perspectives is needed to identify aspects and indicators not captured in this study, followed by a consensus study to finalise safety metrics. Ultimately, having a robust methodology for safety evaluation of virtual consultations in place will enable safety monitoring, root cause analyses and safety improvement.

Prospero registration number: PROSPERO CRD42023464878.

初级保健虚拟会诊的患者安全措施:系统回顾。
目标:随着在初级保健中越来越多地采用虚拟会诊,需要量身定制的指标来评估其安全性变得越来越迫切。本系统评价旨在确定和审查可用于初级保健虚拟会诊安全性评价的现有安全措施。方法:本研究按照系统评价和荟萃分析指南的首选报告项目进行,并遵循已公布的方案。系统检索Ovid MEDLINE/PubMed、Embase和Cochrane Library数据库2014 - 2024年的文献。包括比较初级保健环境中虚拟咨询与面对面咨询的研究。进行归纳主题分析,系统地提取并将安全措施分组为总体主题,并用叙事综合来总结结果。结果:共纳入47项研究(31项实验研究,16项观察性研究)(n=2 223 697例患者)。所有研究都通过以下一个或两个领域评估了虚拟与面对面咨询的安全性:(1)影响虚拟咨询安全性的因素;(2)虚拟护理安全的切实结果。前者分为与提供者相关的因素、与患者相关的因素和与系统相关的因素。通过三个子主题——不良事件、健康结果和患者对安全的感知,可以明显看到切实的结果。结论:本综述为虚拟会诊的安全性评价提供了系统的综合措施。需要对患者和医生的观点进行进一步的研究,以确定本研究未涵盖的方面和指标,然后进行共识研究以最终确定安全指标。最终,拥有一个强大的虚拟咨询安全评估方法将实现安全监测、根本原因分析和安全改进。普洛斯彼罗注册号:普洛斯彼罗CRD42023464878。
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来源期刊
BMJ Quality & Safety
BMJ Quality & Safety HEALTH CARE SCIENCES & SERVICES-
CiteScore
9.80
自引率
7.40%
发文量
104
审稿时长
4-8 weeks
期刊介绍: BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement. The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.
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