Workload effects of online consultation implementation from a Job-Characteristics Model perspective: a qualitative study

Abstract

BackgroundOnline Consultation (OC) was previously promoted by the NHS to solve primary care workload challenges. Its implementation was sped up during the COVID-19 pandemic. Workload effects are widely debated. Using a job design perspective may enhance understandings of workload effect.AimTo qualitatively interrogate the workload experiences of primary care staff involved in OC implementation using Job Characteristics Model (JCM) enabling: clearer understanding of the primary care staff psychological experiences; and recommendations informing the design of digital implementations and continued use.Design & settingA qualitative interview study of GP practices using online consultation within South-West England.Method13 participants representing 7 practices completed JCM based semi-structured telephone interviews. An abductive theoretically driven thematic analysis was completed using NVIVO software.ResultsParticipants experienced qualitatively different tasks pre and post implementation of OC, and adapted differently to this. Differences included: contact modality change, some administrative staff feeling removed from patient contact; and in perceived autonomy, some GPs valuing increased workload control. Variation in workload experience was affected by job role, and practice context, form of and rationale for implementation. Use of a psychological model (the JCM) allowed clearer consideration of the effects of change, as well as OC on workload.ConclusionPsychological theory may be helpful in interpreting workload effects of technology implementation such as OC. Designing change to include consideration of: technology effects, psychological experiences, differences across roles, individuals and practice contexts may be important, for technology implementation and evaluation of its workload effects.

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“…There is a wealth of global evidence confirming that hospital digitalization indeed leads to improved work efficiency, enhanced healthcare quality, and strengthened collaboration and communication (16,17). As reported by Smart et al, online consultation within South West England effectively mitigated the workload and stress of healthcare professionals during the COVID-19 pandemic (18). It is revealed in a multinational study that ophthalmologists were more willing to use AI as clinical assistive tools, indicating that hospital digitalization has received widespread acceptance and support from doctors (19).…”