Assessing the feasibility and acceptability of a pre-clinic vital signs assessment in primary care: a pilot study
Authors: Broughan John , McMahon Seán , Gordon Steen , Ravichandran Nandakumar , Bailey Donal , Grant Jennifer , McCombe Geoff , Sheil James , Cullen Walter 
Published: October 2024

Background

Vital signs assessment can be crucial. However, such assessments are time-consuming and so are not always prioritised. Measuring vital signs before doctor visits may therefore be an effective and efficient strategy. We piloted a pre-clinic vital signs assessment (PCVSA) within a primary care centre to determine its feasibility and acceptability.

Methods

A mixed methods cross-sectional design was piloted. Study participants included adult patients and practice staff. Patients had vital signs assessed by a Primary Care Assistant before GP visits. Data collected concerned participants’ study engagement, the timings of PCVSA / GP visits, and surveys / interviews investigating participants’ experiences.

Results

Sixteen patients and four staff participated. The mean PCVSA was 2mins23secs (SD = 38.8) and the mean GP visit was 9mins21secs (SD = 252.4). Patients said the PCVSA was a ‘Positive experience’ (87%), ‘Helpful’ (81%), ‘Valuable’ (44%), and ‘Interesting’ (38%). The GP said the PCVSA was either ‘Helpful’ (n=8, 54%) or ‘Extremely Helpful’ (n=7, 47%) in each of their consultations, and that it improved engagement with 80% of patients, allowed them to spend more time gaining understanding of the conditions of 93% of patients, and enhanced productivity in 73% of consultations. The GP strongly agreed that collecting PCVSA data before appointments would benefit patients over time. Qualitative interviews with practice staff yielded three themes: (1) Improved patient engagement and efficient consultation, (2) Time-saving potential, and (3) Practicing in general practice and associated challenges.

Conclusion

The PCVSA pilot showed good feasibility and acceptability as indicated by high participant engagement, short PCVSA and GP visit times (albeit GP visit times did not measure non-patient facing clinical activity), and positive feedback from patients and staff. Introducing PCVSA in healthcare settings may have potential in terms of improving the standard and efficiency of care.

Author summary

Checking vital signs is important for patient care, as it helps doctors assess, monitor, and make clinical decisions. However, it is often overlooked to save time for other tasks considered more urgent. A new approach called ‘pre-clinic vital signs assessment’ (PCVSA), where patients’ vital signs are measured before their one-on-one visit with the doctor, may help address this issue. This study tested the PCVSA at a primary care centre in Dublin, Ireland, to see if it could improve care quality, save time, and be accepted by both staff and patients. On average, the PCVSA took 2 minutes and 23 seconds, while the typical doctor visit lasted 9 minutes and 21 seconds. Most patients and staff saw the PCVSA as useful, highlighting its benefits for better patient-doctor communication and timesaving. Some concerns were raised about the extra demand it might place on clinic resources. Overall, the findings suggest that PCVSA could positively impact the quality and efficiency of care in primary care settings, with future research needed to explore its benefits in larger and more varied clinics.