Effect of a redesigned fracture management pathway and ‘virtual’ fracture clinic on ED performance

Vardy, Janette; Jenkins, Paul J.; Clark, Karen; Chekroud, M; Begbie, K; Anthony, Iain; Rymaszewski, L A; Ireland, A J

doi:10.1136/bmjopen-2014-005282

Cited by 70 publications

(61 citation statements)

References 20 publications

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“…It was outwith the scope of this study to quantify the economic savings of this process to the health service. In addition, the redesign has been demonstrated to have no adverse effects on the ED process [6]. …”

Section: Discussionmentioning

confidence: 99%

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Functional outcome and satisfaction with a “self-care” protocol for the management of mallet finger injuries: a case-series

Brooksbank

Jenkins

Anthony

et al. 2014

J Trauma Manage Outcomes

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BackgroundMallet finger injuries are usually successfully treated non-operatively with a splint. Most patients are reviewed at least twice in a clinic after the initial presentation in A&E. A new protocol promoting “self-care” was introduced at our institution. Patients were provided with structured verbal and written information, and given access to a telephone helpline.MethodsA prospective electronic patient record was used to identify all patients who presented to the emergency department with a mallet finger with a minimum six month follow-up. A satisfaction and patient reported outcome measure was administered via a postal questionnaire. The response rate was 36/47 (77%).ResultsThe median QuickDASH score was 2.3 (IQR 0 to 4.6). All patients were satisfied with the treatment plan provided. Nine used the helpline and all were satisfied with information given. Although 13 patients reported some extensor lag, or bump, they had no functional limitation. Seven patients were reviewed by the general practitioner or other clinicians during their treatment period for issues such a skin care, splint size changes or sickness certification. Five were subsequently reviewed at the end of their treatment period in a clinic at their request, or their general practitioner, but did not require further surgical intervention.ConclusionsSelf-care for mallet finger injuries, with adequate patient information and telephone back-up, leads to acceptable functional results and satisfaction.Level of evidence: III

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Section: Discussionmentioning

confidence: 99%

“…The fracture clinic service at our institution has been redesigned through collaboration and consensus between the ED and Orthopaedic clinicians [6]. The aim of this redesign was to provide a safe and effective service that minimised unnecessary review.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome and satisfaction with a “self-care” protocol for the management of mallet finger injuries: a case-series

Brooksbank

Jenkins

Anthony

et al. 2014

J Trauma Manage Outcomes

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show abstract

“…A similar process is in place in regards to fracture clinics. All follow-up decisions are made by consultants, with fractures clinics adapting a 'virtual fracture clinic' model, which had already been established in some trusts before this pandemic (Vardy et al, 2014). There is a focus on the use of removable casts or splints to reduce follow-up requirements.…”

Section: Fracture Clinicsmentioning

confidence: 99%

The impact of the novel coronavirus on trauma and orthopaedics in the UK

et al. 2020

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At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.

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“…The GRI has implemented a validated model of care based on redirecting simple low‐risk injures out of FC with fiscal success simultaneously maintaining patient safety and minimising patient harm. Locally, they reported direct savings for running an FC of £212 705 (AU$371 000) from 2009 to 2014 when compared to the Scottish national average, slower increases in staffing costs (4%, compared to 16% nationally) and reducing overall outpatient attendance (15% compared to 5% countrywide) …”

Section: Discussionmentioning

confidence: 99%

“…The inclusion criteria were based somewhat on previously published criteria by the GRI . However, other injuries not included in the original (GRI) study that were deemed to be suitable for the PCP were also included after careful consideration by the orthopaedic consultants at Logan and Redland Hospitals.…”

Section: Methodsmentioning

confidence: 99%

Do all adult orthopaedic injuries seen in emergency departments need to attend fracture clinic? A Queensland multicentred review

Cleary

Zeller

Maguire

et al. 2017

Emerg Medicine Australasia

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Effect of a redesigned fracture management pathway and ‘virtual’ fracture clinic on ED performance

Cited by 70 publications

References 20 publications

Functional outcome and satisfaction with a “self-care” protocol for the management of mallet finger injuries: a case-series

Functional outcome and satisfaction with a “self-care” protocol for the management of mallet finger injuries: a case-series

The impact of the novel coronavirus on trauma and orthopaedics in the UK

Do all adult orthopaedic injuries seen in emergency departments need to attend fracture clinic? A Queensland multicentred review

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