Patient satisfaction following implementation of a nursing preparation protocol for telehealth visits

Objective: The Covid-19 pandemic prompted broad adoption of telehealth platforms. Our goals were to determine effectiveness of a telemedicine nursing protocol in patient engagement, preparation, and satisfaction. Methods: We implemented a standardized telemedicine nursing protocol prior to a scheduled telehealth visit with a urologic provider at a tertiary care center. Demographic data, telehealth platform and smart device preference, requirement of set up assistance, and rate of success were reviewed. We prospectively administered the Telehealth Usefulness Questionnaire (TUQ), a validated 21-item survey assessing patient satisfaction in 6 domains: Usefulness, Ease of use, Interface quality, Interaction quality, Reliability, and Future use. Scores >105 (>5 for individual items) correlate with high satisfaction. Results: From April - May 2020, 265 patients were included. Demographic data is provided in Table 1. The most commonly used platform for audiovisual visits was Doximity Dialer (85.7%) via Android (50.2%) or Apple (43.0%) smartphone. Eighteen (6.8%) patients reported setup assistance from family/friends. Only 4 (1.8%) were unsuccessful and required conversion to a non-visual phone visit (3 for lack of access to a compatible device;1 for inability to understand instructions). Of these, 186 (70.1%) patients completed the post-visit questionnaire. Mean TUQ scores were 118.31 ± 23.44. Nineteen of 21 individual items had mean scores >5.0. The Usefulness (5.936 ± 1.231) and Interaction Quality (5.89 ± 1.412) subdomains had the highest mean scores. The Reliability subdomain had the lowest mean score (4.715 ± 1.593). Increased TUQ scores were associated with decreased age (P = 0.02) and female gender (P = 0.02). Patients reported high satisfaction with their telemedicine experience regardless of race, marital status, annual income, education level, employment status, or physical distance from clinic but younger age and female gender were associated with greater satisfaction. Conclusions: A standardized nursing protocol designed to maximize patient engagement with telehealth was successful in achieving patient-provider connectivity in 98% of subjects with high patient satisfaction. A team approach to telehealth is recommended.