Are Virtual Fracture Clinics really “safe”? - An evaluation of the capability of a District General Hospital Virtual Fracture Clinic pathway to detect safeguarding issues

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-01-11 DOI:10.1016/j.jcot.2025.102907

Matthew Smitheman, Joseph Heylen, Kathryn Duke, Katy Western, Andrew Keightley, Alexander Dinneen

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引用次数: 0

Abstract

Background

Virtual Fracture Clinics (VFCs) have been widely reported as “safe” in the literature. This is due to exceptionally low rates of missed or incorrect diagnoses and safe management of conditions. However, there has been minimal discussion about the ability of VFCs to identify safeguarding issues.

Methods

All referrals to the Unit's VFC in December 2022 were reviewed. n = 397. Each referral was reviewed to identify diagnosis, outcome, suspicion of safeguarding, type of healthcare professional referring and whether the specific safeguarding “check box” had been completed.

Allied healthcare professionals (AHPs) involved in the VFC were invited to complete a questionnaire to determine their level of training and confidence in managing safeguarding issues.

Results

Review of the VFC referrals showed most were from advanced nurse practitioners. 55 % of referrers did not engage with the specific safeguarding section on the referral. Of these 13 cases were suspicious for a safeguarding issue, of which 3 were subsequently not seen in a fracture clinic: 2 triaged to physiotherapy, 1 discharged. These could represent missed safeguarding opportunities.

Review of questionnaire response showed that 86 % of respondents were up to date with mandatory safeguarding training. On average respondents felt “confident” managing safeguarding. However, the majority felt they wanted more teaching on safeguarding.

Conclusion

Whilst VFCs have been deemed “safe” with regards to fracture management, they may not be “safe” with regards to identification of safeguarding issues. This project demonstrates the main issues are poor quality referrals and the missed opportunity for a healthcare professional, appropriately trained in safeguarding, to assess the patient face to face.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.