GPs intentions to use organizational practice changes from the pandemic prospectively

Yelda Idik, Simon Kugai, Manuela Schmidt, Birgitta Weltermann

Background:
The vast majority of COVID patients is treated in ambulatory care. To implement hygiene and distancing regulations, many practices changed their organisational routines as recommended by the German College of General Practitioners. We aimed at understanding GPs´ intention to continue these changes prospectively.

Research questions:
Which organizational changes required during the pandemic do GPs plan to use prospectively?

Method:
In Spring 2021, we performed a web-based, nationwide survey among GPs. The GP sample was drawn as a stratified random sample with proportionate allocation by population density and practice type. The questionnaire addressed GP and practice characteristics as well as GPs assessment of practice changes. A Net-Promotor Score obtained GPs intention to use new structures and processes prospectively. The score ranged from +100 [highest interest in future use] to -100 [no interest in future use].

Results:
In total, 630 of 10,180 GPs completed the questionnaire (participation rate: 9.3 %). On average, GPs were practicing since 18.8 years (SD±9.6), 57.8% were male, and 10.2% reported COVID infections of practice personnel. In decreasing order, the net-promoter scores were as follows: disinfectant dispensers at entrance (NPS=56.2); optimized consultation scheduling to reduce waiting times (NPS=33.6); glass screens at reception (NPS=18.4); separate consultations for infectious patients (NPS=6.9); face masks obligatory for patients with respiratory infections (NPS=5.5); testing for COVID only if personal protective equipment is sufficient (NPS=5.0); phone consultations for patients with respiratory infections (NPS=2.9); prescriptions by mail (NPS= -11.0); smartcard reader handled by patients (NPS= -16.7); selected staff treats infectious patients (NPS= -35.0); video consultations for patients with infections (NPS= -63.5).

Conclusions:
GPs support organizational learning from the pandemic, yet asynchronous treatments options are not preferred. Current German billing regulations which require patients to be seen in person may play a role and need to be reconsidered.

Points for discussion:
organizational changes

pandemic preparedness

Net-Promoter Score