ARM@DA - Certificate of Completion.

C: reminds us to create the right environment, infrastructure and support for staff.

0: is for optimising consultations to be responsive, flexible and personalised to different needs and preferences.

R: is about recognising the importance of access and inclusion.

E: refers to enabling quality and safety through relational connections.

Creating the right environment for a consultation needs attention to lots of different factors:

Healthcare Provider: Digital clinical consultations are different to those conducted face to face. As with all communication skills, training can improve our practice. Have you had any training about how to do effective digital clinical consultations? What training could you access?

Door: Is there privacy to talk about confidential matters? Consider if you will you be able to talk uninterrupted and how you will convey privacy to the woman.

Computer: If using video calls, do you have a stable internet connection? It is always good to have a back-up plan if something goes wrong. Where possible, choose a communication platform that is easy for women to use.

Phone: Always use a work phone and make sure women know your work phone number, and an alternative contact number if you are not available at work.

Door: Do you have access to this woman's medical and maternity records? Both handheld and electronic records should be checked as the two systems do not always link up. Where possible, the system you are using should link to electronic records. Make sure that any discussions are documented.

Medical Notes: Do you have access to this woman's medical and maternity records? Both handheld and electronic records should be checked as the two systems do not always link up. Where possible, the system you are using should link to electronic records. Make sure that any discussions are documented.

Protocols: Are there organisational guidelines that support the use of digital clinical consultations for different situations? Make sure you find out who you can ask for help if you encounter any problems.

Book/ Directory: Does the client need an interpreter? If so, make sure you have booked this service in advance and that you are familiar with how to use the system. You may need to access training to make maximum use of the interpretation facility.

Team Photo: Would it be helpful to involve any other professionals in the call? Digital consultations can be a very efficient way of holding an appointment with a multi-disciplinary team.

Introductions:Make sure you introduce yourself and your role so that women know who they are talking to.

Evaluation Dashboard:It is important to monitor women's and staff's experiences of using digital clinical consultations. Make sure the results are communicated to staff so that they feel involved in decisions about how and when to use digital clinical consultations.

Curious friend: The presence of a curious friend during an online consultation could raise potential safeguarding concerns, as they may inadvertently overhear or gain access to sensitive information, compromising the confidentiality of the session.

Landline Phone: A landline phone can be a valuable tool in distance consultations, offering a stable and reliable connection, especially in areas with poor mobile signal or unreliable internet. When advising a woman planning to use a landline, it is helpful to check whether the woman’s phone line is in good working condition and has no call restrictions, such as call waiting or call forwarding, which could disrupt the consultation. Emphasize the importance of choosing a quiet and private location for the call to maintain confidentiality and suggest having a pen and paper ready to take notes during the consultation. Additionally, advise the woman to test the phone connection in advance to ensure a smooth and uninterrupted conversation with their healthcare provider.

Child playing with Dog: The child playing with dog could be potentially distracting if mother is concentrating on an online meeting.

Low or no funds in electricity meter: The lack of funds for the electricity pay meter could disrupt the meeting by causing an unexpected power outage, leading to delays and potential interruptions.

Poor Internet/WIFI Connection: A poor internet connection can hinder the quality of an online consultation by causing video and audio lags, making it difficult to effectively communicate and share important medical information and advice.

High noise levels: High noise levels from children playing inside the flat and everyday noises outside can significantly disrupt an online consultation, making it challenging for both the healthcare provider and patient to hear and concentrate on the conversation.