Hello, can you hear me? Orthopaedic clinic telephone consultations in the COVID-19 era- a patient and clinician perspective

Table 1 Inclusion and exclusion criteria

Inclusion criteria	Exclusion criteria
Adult patients aged ≥ 18 years of age	Patients aged < 18 yr of age
Received orthopaedic clinic telephone consultation	If other members of the family responded on patient’s behalf
Satisfaction questionnaire completed within 48 h from telephone consultation	Unable to consent to complete satisfaction questionnaire
	Communication difficulties (verbal or auditory) as stated in patient clinical notes
	Cognitive impairment as stated in patient clinical notes
	If patients did not answer their telephone on two occasions to complete the satisfaction questionnaire

Table 2 Summary of patient satisfaction levels (%)

Scale	Explanation of condition	Outcome of consultation	Answers received to all questions	Overall satisfaction	Willingness for future telephone consultations
Very satisfied	51	47	46	56	44
Satisfied	40	45	45	37	35
Neutral	6	6	4	2	10
Dissatisfied	3	2	3	4	3
Very dissatisfied	0	0	2	1	8

Table 3 Free text feedback from patients

Positives		Negatives
Logistical advantages	A better way to avoid coming to hospital during COVID-19	Lack of visual feedback	More explanation of X-ray required as I could not see it
	Good and efficient way to receive results		Video conferencing would be an improvement e.g., Skype/Zoom
	Great service to be seen at home		Prefer F2F to show doctor the deformity
	Telephone consultations made the process quicker than attending the hospital for an appointment	Consultation timings	Was not expecting telephone consultation, a pre-warning text message may have helped
Overall Satisfaction	Very satisfied - doctor really listened and able to ask questions		No specific time given, better to have one hour slots or “window”
	Very clear and precise	Patient confidence	Would prefer F2F for first appointment
	Doctor was very helpful		Prefer F2F for more support with condition
	Doctor very friendly		Needed to guess whether exercises were being done correctly
	Pleasant doctor		With elderly patients important to advise to have someone accompany them on the telephone call on loudspeaker

Table 4 P values for Fisher’s exact test in level of satisfaction between age, gender and diagnosis of upper or lower limb injuries

P value (≤ 0.05)
		Age	Gender	Diagnosis of upper or lower limb injuries
Question 1	Willingness for telephone consultation in the current pandemic	0.31	0.32	> 0.99
Question 2	Explanation of condition	> 0.99	0.09	0.25
Question 3	Outcome of consultation	0.71	0.48	0.25
Question 4	Answers received to all questions	> 0.99	0.31	0.14
Question 5	Overall satisfaction	> 0.99	0.11	0.41
Question 6	Willingness for future telephone consultations	0.81	0.33	0.43

Table 5 Free text suggestions from clinicians

Suggestions
Lack of visual feedback
Visual consultations would be a great improvement and improve quality of consultation
Video software that will also allow sharing of clinicians’ screen would be more informative as imaging can be shown
Workload
Dedicated administrator for telephone consultation preparation would be useful
Lack of examination
Difficult to examine patients. Often reliant on family or patient’s own interpretation of examination
Could be limited to follow ups only
Difficult to build rapport or trust