Patient Preparation in Walk-in Clinics Through the Implementation of a Consultation Preparation Sheet: Qualitative Study.

Abstract

Background: Effective communication is essential for high-quality care, yet in walk-in clinics, patients often have limited time to prepare, and physicians face challenges in understanding patients' needs due to lack of prior contact. To address this, a consultation preparation sheet (CPS) was developed to help patients articulate their symptoms, concerns, and expectations.

Objective: This study aimed to explore the implementation and perceived usefulness of a CPS designed to support patient preparation during walk-in clinic consultations.

Methods: We conducted a qualitative exploratory study using semistructured interviews and focus groups, with data collection informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework and the PACE (prepare, ask, check, and express) method. The CPS was implemented over 9 months (January-October 2019) in a university-affiliated walk-in clinic in Quebec, Canada. During this period, 3115 patients received the CPS in the waiting room. Of the 23 patients who expressed interest in further participation, 12 were recruited for interviews. Additional participants included 2 physicians, 2 administrative staff, 2 nursing assistants, and 1 clinic manager. In total, 6 interviews and 5 focus groups were conducted. Data were transcribed verbatim and thematically analyzed, with AI-assisted review used as a supplementary check on data coverage.

Results: Patients generally found the CPS helpful for organizing their thoughts, reducing stress, and avoiding omissions during consultations. It was considered particularly useful for patients with multiple concerns or communication difficulties. However, physicians rarely referred to the CPS, often preferring direct verbal exchanges. This lack of acknowledgment sometimes frustrated patients and diminished their perception of its usefulness. Organizational challenges-including inconsistent distribution, lack of explanation, and an unclear workflow-further hindered implementation. Participants suggested clearer communication about the CPS's original purpose, earlier access through electronic formats, and brief clinician acknowledgment when patients chose to share their priorities.

Conclusions: The CPS shows promise as an optional patient-preparation tool for walk-in consultations. Earlier access and a clear explanation may support its use without requiring formal clinician review; brief acknowledgment may suffice when patients choose to share their priorities. Future studies should assess improved practice implementation strategies and digital adaptations.