Incorporating SPACES recommendations to the COVID-19 ward care approach at the Royal Bournemouth Hospital

Abstract

The British Thoracic Society have published SPACES (Sharing Patient Assessments Cuts Exposure for Staff) guidance recommending the use of telecommunications as a means of inpatient clinical assessment during the COVID-19 pandemic. The aim of this audit was to reduce face-to-face exposure time during inpatient care of patients with suspected/confirmed COVID-19 using a telecommunications-based approach. 76 patients were included in the audit. 46 patients were included in cycle 1, which measured the average face-to-face time for clinical consultation per patient. 30 patients were included in cycle 2, whereby history-taking was conducted using telecommunications and, if required, face-to-face physical examination. Average face-to-face exposure time was reduced to a median of 0 seconds (IQR 0–146.3 seconds) in the telecommunications group, from a median of 312.5 seconds (IQR 178.8–442.3 seconds) in the comparator group (p<0.0001). Patient satisfaction was high with individuals’ responses revealing a perception of improved safety by maintaining social distancing. No adverse events were noted. The audit confirms telecommunications can be integrated successfully into the daily inpatient ward round structure, reducing face-to-face exposure time while maintaining patient satisfaction and safety.