A Service Evaluation after 4 year’s use of the Virtual Fracture Clinic model by a District General Hospital in the South West of England.

Thelwall, Claire

doi:10.1016/j.ijotn.2020.100798

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…Patients seen in the UTC and ED with musculoskeletal complaints have their management streamlined via a virtual fracture clinic (VFC) emergency management pathway. Virtual fracture clinics are well established in the United Kingdom with multiple studies confirming reasonable patient satisfaction [6,7], good clinical outcomes, overall improved efficiency of trauma services, cost savings [6,8], safety [9], reduced unplanned ED reattendances [10] and invaluable time for the T&O service to focus on more complex cases [11]. Our Trust's VFC pathway consists of a traffic light system of musculoskeletal diagnoses, from which practitioners can safely discharge with written advice (green), refer to the VFC (yellow) or refer to the on-…”

Section: Introductionmentioning

confidence: 99%

Assessing Referrals to a Trauma and Orthopaedic Department: Evaluation of a Traffic Light System for Virtual Fracture Clinic in the Emergency Department and Urgent Care

Menyah,

Garcia,

McCormack

et al. 2023

Cureus

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Background The Trauma and Orthopaedic (T&O) on-call service receives referrals from the emergency department (ED), general practice (GP) and urgent treatment centres (UTCs) and requests for inpatient reviews. The virtual fracture clinic (VFC) pathway allows ED and UTC clinicians to assess, discharge and refer when necessary. For VFC, the on-call orthopaedic consultant reviews the cases the next working day and makes an appropriate plan. This pathway consists of a traffic light system, in which practitioners can either safely discharge with written advice (green), refer to the VFC (yellow) or refer to the on-call team (red). Method The aim of this study was to assess how the VFC pathway was being utilised. All referrals to the T&O on-call team over three weeks were evaluated retrospectively. The following referrals were excluded: fractured femur, head injury, trauma calls and back pain pathway. The following data were collected: patient details, diagnosis, referral source, reason for referral, plan, double booking with VFC and appropriateness. Results A total of 191 referrals were analysed. Most referrals are from the ED (51%) and UTC (23%). Of the referrals, 39% were deemed to be inappropriate. Of the inappropriate referrals, 35% should have been referred directly to the VFC rather than the on-call team. A significant minority (7%) of inappropriate referrals were referred to the on-call team and VFC. Conclusion Education and collaboration are required with the ED and UTC to ensure the proper use of the VFC pathway. Immediate radiograph reporting may also be beneficial.

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Section: Introductionmentioning

confidence: 99%

Assessing Referrals to a Trauma and Orthopaedic Department: Evaluation of a Traffic Light System for Virtual Fracture Clinic in the Emergency Department and Urgent Care

Menyah,

Garcia,

McCormack

et al. 2023

Cureus

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“…Health care providers face challenges to innovate their services, such as with mobile health (mHealth) app, to continuously reduce mortality rates as well as to strike the right balance between time and other resource investments and the optimization of patient experiences of health and service quality [ 9 ]. For example, virtual fracture clinics limit the use of resources in caring for patients with simple and stable fractures while ensuring consistent quality of care [ 9 , 10 ]. This model also appeared to be useful when the COVID-19 pandemic forced (orthopedic) outpatient clinics to limit face-to-face consultations [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Developing mHealth to the Context and Valuation of Injured Patients and Professionals in Hospital Trauma Care: Qualitative and Quantitative Formative Evaluations

Houwen¹,

Vugts²,

Lansink³

et al. 2022

JMIR Hum Factors

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Background Trauma care faces challenges to innovating their services, such as with mobile health (mHealth) app, to improve the quality of care and patients’ health experience. Systematic needs inquiries and collaborations with professional and patient end users are highly recommended to develop and prepare future implementations of such innovations. Objective This study aimed to develop a trauma mHealth app for patient information and support in accordance with the Center for eHealth Research and Disease Management road map and describe experiences of unmet information and support needs among injured patients with trauma, barriers to and facilitators of the provision of information and support among trauma care professionals, and drivers of value of an mHealth app in patients with trauma and trauma care professionals. Methods Formative evaluations were conducted using quantitative and qualitative methods. Ten semistructured interviews with patients with trauma and a focus group with 4 trauma care professionals were conducted for contextual inquiry and value specification. User requirements and value drivers were applied in prototyping. Furthermore, a complementary quantitative discrete choice experiment (DCE) was conducted with 109 Dutch trauma surgeons, which enabled triangulation on value specification results. In the DCE, preferences were stated for hypothetical mHealth products with various attributes. Panel data from the DCE were analyzed using conditional and mixed logit models. Results Patients disclosed a need for more psychosocial support and easy access to more extensive information on their injury, its consequences, and future prospects. Health care professionals designated workload as an essential issue; a digital solution should not require additional time. The conditional logit model of DCE results suggested that access to patient app data through electronic medical record integration (odds ratio [OR] 3.3, 95% CI 2.55-4.34; P<.001) or a web viewer (OR 2.3, 95% CI 1.64-3.31; P<.001) was considered the most important for an mHealth solution by surgeons, followed by the inclusion of periodic self-measurements (OR 2, 95% CI 1.64-2.46; P<.001), the local adjustment of patient information (OR 1.8, 95% CI 1.42-2.33; P<.001), local hospital identification (OR 1.7, 95% CI 1.31-2.10; P<.001), complication detection (OR 1.5, 95% CI 1.21-1.84; P<.001), and the personalization of rehabilitation through artificial intelligence (OR 1.4, 95% CI 1.13-1.62; P=.001). Conclusions In the context of trauma care, end users have many requirements for an mHealth solution that addresses psychosocial functioning; dependable information; and, possibly, a prediction of how a patient’s recovery trajectory is evolving. A structured development approach provided insights into value drivers and facilitated mHealth prototype enhancement. The findings imply that iterative development should move on from simple and easily implementable mHealth solutions to those that are suitable for broader innovations of care pathways that most—but plausibly not yet all—end users in trauma care will value. This study could inspire the trauma care community.

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Virtual Fracture Clinic Model in India: A Technological Innovation

Iyengar

Jain²,

Nallakumarasamy³

et al. 2022

JOIO

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A Service Evaluation after 4 year’s use of the Virtual Fracture Clinic model by a District General Hospital in the South West of England.

Cited by 6 publications

References 14 publications

Assessing Referrals to a Trauma and Orthopaedic Department: Evaluation of a Traffic Light System for Virtual Fracture Clinic in the Emergency Department and Urgent Care

Assessing Referrals to a Trauma and Orthopaedic Department: Evaluation of a Traffic Light System for Virtual Fracture Clinic in the Emergency Department and Urgent Care

Developing mHealth to the Context and Valuation of Injured Patients and Professionals in Hospital Trauma Care: Qualitative and Quantitative Formative Evaluations

Virtual Fracture Clinic Model in India: A Technological Innovation

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