How Florence is Extending the Reach of Primary Care Remotely During COVID-19

Rudy Mckinney is a Nurse Practitioner working within Northern Staffordshire CCG who has been implementing Flo during the COVID-19 pandemic.  Rudy has kindly shared her experiences with us.

What is your background and role within your organisation?

I am a Nurse Practitioner working in primary care within North Staffordshire CCG.  Around two years ago I took part in the Digital Nurse Programme which introduces digital technologies, including Flo, into our day to day consulting with patients.  We did some fantastic work as a surgery implementing technology into our daily practices – this resulted in the publication of a journal article that detailed our work and gained digital exemplar status for our surgery.  To read the articles in more detail please click here for The Atlas of Shared Learning – Digital Applications for self-management at Audley Health Centre and here for Digital by choice: becoming part of a digitally ready general practice team.

The recent pandemic has given us the opportunity to strengthen the foundation work that we had in place and our use of technology, in particular Flo, has grown from strength to strength.

How did you first hear about Flo?

I heard about Flo when I attended the Digital Nurse Programme in 2018.  The programme provided digital training and support for 40 primary care nurses; of which I was included, from across Staffordshire who were each tasked with developing action plans on how they would like to use technology with patients.  We were shown innovative practice in the use of social media, apps, Flo and video consultation and then asked to develop our actions plans.

What in particular ignited your passion to develop Flo?

My passion for Flo in particular came from actually using the service with patients.  We now use her in many areas of our consulting, we have found that implementing Flo with patients for medication and injection prompts has been particularly helpful with improving patient compliance.

Flo’s inhaler reminders work fantastically for our teenage asthma population that are often poorly compliant with their treatment. We have found that having the reminder nudge sent directly to the patient gives them an increased sense of ownership and has consequently improved compliance, whereas before they had a lot of unwanted nagging from their parents.

Flo has been particularly helpful to both staff and patients during the pandemic.  It has allowed us to facilitate remote consulting more easily – especially with having to limit the number of patients visiting the surgery for face to face appointments.

Flo’s blood pressure pathway has been especially useful for this.  It has allowed us to safely continue prescribing, knowing the patient is supported to submit their blood pressure readings.  We have had excellent feedback from patients – some of whom have been shielding and therefore have been unable to attend the surgery in person.  We also find that our working patients much prefer this type of remote consulting as they often find it hard to attend appointments due to the clash between surgery opening times and their working hours.

Improving medication adherence has been even more important during the pandemic where often housebound and frailer patients are having less input from families / carers due to the restrictions of the lockdown.  We also use the respiratory pathway for monitoring oxygen saturations of some of our more brittle respiratory patients – this has allowed us to monitor them closely and safely when needed, and provided them with peace of mind during such a worrying period.

What improvements did you expect to deliver from integrating Flo?

Flo has allowed our surgery to work more effectively using remote consulting techniques.  During the pandemic, Flo has improved safety as she has allowed us to continue to monitor our patients who we would not have been able to review in the surgery period.

Flo has increased patient compliance and also reported an increase in patient satisfaction.

Implementing Flo has also saved us time – it limits the reminders we need to send to patients as Flo automatically does this for us.  It is also saving us time by reviewing a patient’s submitted readings and only contacting them if needed – previously a whole appointment would have been needed for each of our hypertensive patients.  This has in turn increased our appointment capacity for other things that need a face to face appointment.

What were your first steps towards integrating Flo?

To start I would recommend focusing on one area and get used to how Flo works and begin to see the benefits.  Once you are more competent, then see what other patient cohorts could benefit from becoming more active in their self management.  If you have resistance from other staff members then show them the benefits that happen once Flo starts to support your patients and always collate patient feedback.  We found it didn’t take long to get everyone on board once we could share the benefits with them.

Would you recommend Flo to others?

I would strongly recommend Flo to others, particularly at this time during the pandemic – it is a fantastic time to start.

We have found patients that were previously resistant to using technology are now much keener to try.  Patients are often worried to attend healthcare settings, or even leave their house during the pandemic – Flo allows you to continue to offer a fantastic, safe service but remotely.

#Medication #Injections #Reminders #Asthma #Blood Pressure #Hypertension #COVID-19 #Coronavirus #Remote monitoring #Staffordshire #TotallyUnique

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