Browse by author
Lookup NU author(s): Shiv Kolhe
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
© 2024Background: Virtual fracture clinics (VFCs) are advocated by the British Orthopaedic Association Standards for Trauma (BOAST). We aimed to assess the impact of the transition from face-to-face fracture clinic review and identify any change in clinical outcome and patient satisfaction. Methods: A national, cross-sectional cohort study of VFCs across the UK over two separate two-week periods pre- and during the first UK COVID-19 lockdown was undertaken. Data comprising patient and injury characteristics, unplanned reattendance and complications within three months following discharge from VFC were collected by local collaborators. Telephone questionnaires were conducted to determine patient satisfaction and patient-reported outcome for patients discharged without face-to-face consultation. The primary outcome measure was the percentage of unplanned reattendances after direct discharge from VFC. Results: Data was analysed for 51 UK VFCs comprising 6134 patients from the pre-pandemic group (06/05/2019–19/05/2019) and 4366 patients from the first UK lockdown (04/05/2020–17/05/2020). During lockdown, the rate of direct discharge from VFC increased significantly (odds ratio (OR) 2.01, p<0.001) from 30 % (n = 1856/6134) to 46 % (n = 2021/4366). The rate of compliance with BOAST guidance recommending fracture clinic review within three days increased (OR 1.93, p<0.001) from 82 % (n = 5003/6134) to 89 % (n = 3883/4366). There were no differences in the rates of unplanned reattendance (6 % pre- and 7 % during lockdown, p = 0.281) or complications (0.2 % for both, p = 0.815). There were 1527/3877 patients discharged without face-to-face review from VFC who completed telephone questionnaires (mean follow-up 18-months in pre-pandemic group and 6-months in lockdown group). Satisfaction was high in both cohorts (80 % pre- and 76 % lockdown, p = 0.093). Dissatisfaction was associated with an unplanned reattendance (p<0.001) or a missed injury (p<0.05). Conclusion: Despite a significant rise in direct discharge from VFC, there was no significant change in unplanned attendances, complications, or patient satisfaction. However, there are factors associated with dissatisfaction and these should be considered in the evolution of VFC.
Author(s): Ng ZH, Downie S, Makaram NS, Kolhe SN, Mackenzie SP, Clement ND, Duckworth AD, White TO
Publication type: Article
Publication status: Published
Journal: Injury
Year: 2024
Volume: 55
Issue: 3
Print publication date: 01/03/2024
Online publication date: 09/02/2024
Acceptance date: 01/02/2024
ISSN (print): 0020-1383
ISSN (electronic): 1879-0267
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.injury.2024.111399
DOI: 10.1016/j.injury.2024.111399
PubMed id: 38340424
Altmetrics provided by Altmetric
