Orthopaedic Walk-In Clinics: A model to lessen the burden on Emergency Departments during the COVID-19 pandemic

MacKechnie, Madeline C.; Nadeau, Molly; Deering, Ericka; Thaller, John; MacKechnie, Michael A

doi:10.1016/j.jor.2020.05.014

Cited by 10 publications

(12 citation statements)

References 8 publications

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“…Following the initial title/abstract screen, 78 articles were assessed for eligibility in the full-text phase. Ultimately, 48 studies met the inclusion and exclusion criteria and were included for analysis [ 1 , 3 , 4 , 5 , 6 , 7 , 10 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. All of these studies were categorized as level IV or level V Evidence, representing low-quality studies ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-five studies documented the impact of COVID-19 on future clinical or operational workflow ( Table 2 ) [ 4 , 5 , 6 , 7 , 10 , 11 , 15 , 18 , 19 , 22 , 24 , 26 , 29 , 30 , 32 , 33 , 35 , 37 , 38 , 41 , 44 , 45 , 49 , 50 ]. Of these, fourteen studies detailed the importance of establishment and updating of an effective COVID-19 screening protocol [ 5 , 6 , 10 , 11 , 18 , 19 , 22 , 24 , 26 , 29 , 32 , 33 , 37 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies discussed the importance of outpatient orthopedic surgery practice in the COVID-19 era [ 4 , 5 , 19 , 22 , 35 , 37 , 38 , 49 ]. Meneghini et al noted that outpatient elective surgery would save inpatient hospital beds for COVID-19 patients, but that this alteration would result in the challenge of doing the more complex surgeries with increased blood loss in an outpatient setting with potential limitations including inexperienced staff, insufficient physical space, and inadequate central sterile processing capacity [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Further, O’Connor et al noted that the hours of outpatient surgery would need to be extended to keep up with the backlog in surgical cases and that those necessitating traditional inpatient surgery should be shifted to rapid recovery protocols [ 4 ]. Lastly, MacKechnie et al described their experience in implementing an outpatient orthopedic walk in clinic, which was able to significantly reduce non emergent musculoskeletal emergency department referral by 40% [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Total Joint Arthroplasty During the COVID-19 Pandemic: A Scoping Review with Implications for Future Practice

Chen¹,

Shen²,

Bovonratwet³

et al. 2021

Arthroplasty Today

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Total Joint Arthroplasty During the COVID-19 Pandemic: A Scoping Review with Implications for Future Practice

Chen¹,

Shen²,

Bovonratwet³

et al. 2021

Arthroplasty Today

View full text Add to dashboard Cite

“…Such sub-teams provide emergency and outpatient services to orthopaedic patients while the rest are shielded from the pandemic. These dedicated centres could potentially serve as a model for other surgical and medical subspecialty clinics both during and after the COVID-19 pandemic [18].…”

Section: Country Of Originmentioning

confidence: 99%

Impact of COVID-19 on Orthopaedic Care and Practice: A Rapid Review

Chatterji

Patel

Jain

et al. 2021

IJOO

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Introduction The COVID-19 pandemic has led to a large body of literature regarding the impact of COVID-19 on orthopaedic care and practice. This rapid review aims to synthesize this published literature to give the orthopaedic fraternity an overview about the best practices that need to be followed during this period. Methodology A rapid review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement for rapid reviews on the impact of COVID-19 on orthopaedic care and practice. A Pubmed search was done to identify all literature related to the impact of COVID-19 on orthopaedic care and practice, published between December 2019 and October 2020 using a predefined search strategy. The final review included 375 peer-reviewed articles addressing the objectives. Results The majority of articles were expert opinions (37.1%) and narrative reviews (13.1%). There were 17.3% retrospective studies and 2.1% prospective studies with only one randomized control trial and ten systematic reviews. 83.8% of articles had levels of evidence IV and V, 79.5% of the articles were published in core-orthopaedic journals. Maximum publications were from the United States of America (31.7%), followed by India (11.5%). European countries together contributed to 32.0% of all publications. Conclusion COVID-19 has had a significant impact on all aspects of orthopaedic care and practice. The pandemic has affected outpatient clinics, emergency and elective surgery, rehabilitation, resident training, personnel management, use of personal protective equipment, telemedicine and all sub-specialities of orthopaedics. Orthopaedic practice will require the incorporation of new technologies, restructuring of health systems and reorganizing of training programs for optimal patient care. There would also be a need for frequent review of emerging literature to provide evidence-based guidelines to the orthopaedic fraternity which will not only help in mitigation of transmission of disease but also ensure continuity of optimum patient care.

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Effect of the COVID-19 pandemic on CT scans ordered from the emergency department for abdominal complaints

et al. 2021

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Purpose The COVID-19 pandemic has affected healthcare systems and patients alike across the USA. We seek to elucidate changes in abdominal imaging ordered from the emergency department (ED) in a healthcare system undergoing non-surge conditions in April 2020 compared to April 2019. Methods We performed a retrospective, observational study comparing patients undergoing CT scans of the abdomen and pelvis ordered from the ED in April 2020 vs. April 2019 at a single healthcare center. Via review of the radiology report and electronic medical record, we determined the positive or negative status of these scans. We evaluated percentages of positive CT scans and differences in outcomes, including admission rates, interventions, and mortality. Results Comparing 2020 to 2019, there was a 31.6% decrease in the number of CT scans performed from the ED. We found a higher percentage of positive CT findings, 58.2% vs. 50.8% (p = 0.025), and increased admission rates, 40.8% vs. 34.1% (p = 0.036). Differences were found in rates of appendicitis, colitis, and cholangitis. No difference was found in ICU admissions, interventions, or in-hospital mortality. Conclusion During the COVID-19 pandemic in a region undergoing non-surge conditions, we found increased rates of positive CT scans performed from the ED for abdominal complaints with an increased percentage of hospital admissions compared to a control year. No differences in ICU admissions or rates of procedural intervention were found to suggest higher acuity of pathology on presentation. Our findings suggest appropriately decreased healthcare utilization in our study period, driven by pre-hospital patient self-selection.

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Orthopaedic Walk-In Clinics: A model to lessen the burden on Emergency Departments during the COVID-19 pandemic

Cited by 10 publications

References 8 publications

Total Joint Arthroplasty During the COVID-19 Pandemic: A Scoping Review with Implications for Future Practice

Total Joint Arthroplasty During the COVID-19 Pandemic: A Scoping Review with Implications for Future Practice

Impact of COVID-19 on Orthopaedic Care and Practice: A Rapid Review

Effect of the COVID-19 pandemic on CT scans ordered from the emergency department for abdominal complaints

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