Impact of the COVID-19 Pandemic on the Implementation and Adoption of a Virtual Fracture Clinic Pathway: A Closed Loop Audit.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-12-24 eCollection Date: 2024-12-01 DOI:10.7759/cureus.76317
Daire-Sean Gibbons, Aaron A Glynn
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Abstract

Introduction: Trauma and orthopedics departments have traditionally used face-to-face (FTF) fracture clinics for non-operative fractures. Developed in 2011, the virtual fracture clinic (VFC) was fully implemented at an institution during the COVID-19 pandemic to reduce in-person interactions.

Aims: First, the study aims to measure the percentage of non-operative patients triaged through the VFC when this was optional and re-audit after implementing a COVID-19-related policy change mandating VFC triage. Second, the study aims to measure the number of FTF fracture clinic interactions and re-audit after implementing three policies: national COVID-19 lockdowns, mandated VFC triage, and early appropriate discharge.

Methods: Data from two periods were examined, pre-pandemic (2018-2020) and pandemic (2020-2022), at a university teaching hospital. We measured compliance with modified British Orthopaedic Association Standards for timely senior review, minimizing outpatient visits, and patient-initiated follow-up.

Results: The percentage of cases triaged to the VFC rose from 39% to 100%. FTF fracture clinic interactions dropped by 50.2% from 35,399 to 17,639. All three policy changes reduced FTF numbers: 3.7% due to national lockdowns, 14.7% due to VFC triage, and 35.5% due to early appropriate discharge.

Conclusions: The COVID-19 pandemic provided a window in which healthcare working partners were more receptive to change. Our institution successfully used this opportunity to implement policy changes that improved patient care and maximized resources.

COVID-19大流行对虚拟骨折诊所路径实施和采用的影响:闭环审计
简介:创伤和骨科传统上使用面对面(FTF)骨折诊所非手术骨折。虚拟骨折诊所(VFC)于2011年开发,在2019冠状病毒病大流行期间在一家机构全面实施,以减少面对面的互动。目的:首先,该研究旨在衡量非手术患者通过VFC分类的百分比,当这是可选的,并在实施与covid -19相关的政策变更后强制进行VFC分类后重新审计。其次,本研究旨在衡量在实施国家COVID-19封锁、强制性VFC分诊和早期适当出院三项政策后FTF骨折临床互动和重新审计的次数。方法:对某大学教学医院大流行前(2018-2020年)和大流行期(2020-2022年)两个时期的数据进行分析。我们根据修改后的英国骨科协会标准,及时进行高级复查,减少门诊就诊和患者主动随访。结果:分诊到VFC的病例比例从39%上升到100%。FTF骨折临床互动从35,399下降到17,639,下降了50.2%。所有三项政策变化都减少了FTF数量:3.7%归因于国家封锁,14.7%归因于VFC分诊,35.5%归因于早期适当出院。结论:2019冠状病毒病大流行为卫生保健工作伙伴提供了一个更容易接受变革的窗口。我们的机构成功地利用这个机会实施了政策改革,改善了病人的护理,最大限度地利用了资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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