Out Patient Department practices in orthopaedics amidst COVID-19: The evolving model

Abstract

Severe Acute Respiratory Syndrome COVID-19 was declared as a pandemic on 11 th March 2020 by the World Health Organization and consequent lockdown imposed in several areas resulted in a marked reduction in orthopaedic practices. Although some guidelines for patient care in orthopaedic practice have been published, overall, publications focusing exclusively on guidelines on starting orthopaedic outpatient departments (OPD) after the COVID-19 lockdown amidst the on-going pandemic are lacking. We hereby propose the evolving knowledge in changes in OPD management practices for orthopaedic surgeons in the COVID-19 era. The emphasis on online registration (e-registration) should be given impetus and become the new norm supplemented by telephonic and spot registration for the uneducated patients. The review highlights the safety of patient and orthopaedic surgeons in OPD by screening and maintaining hygiene at various levels.The article also mentions the duties of the help desk, OPD hall supervisor and the new norms of air conditioning, ventilation, safe use of elevators, sanitization of OPD premises and biomedical waste disposal. The optimum and safe utilization of human & material resources, DO's and DON'Ts for patients & health staff have also been proposed. The reorganization of plaster room, the precaution during plastering, fracture clinic, dressing and injection room services are discussed as per evolving guidelines. This article will also give deep insight into the OPD plan & telemedicine graphically.The authors suggest updating and downward permeation of existing e-infrastructure of government health services that is up-gradation of existing tertiary level online registration services, a paperless model of OPD consultation & dispensation. The future updating of Aarogya Setu App (https://mygov.in/ aarogya-setu-app/) for convenient online OPD registration and dispensation has been discussed and proposed. This review will help in containing the spread of COVID 19 and build upon the health gains achieved after lockdown. The easy concept of CCCATTT has been introduced, and the OPD Plan has also been suggested. We have endeavoured to holistically detail an orthopaedic OPD setup and its upkeep in COVID-19 pandemic, but since the knowledge of COVID 19 is ever-evolving it needs replenishment by regular education for health staff.

Impact of COVID-19 on post-graduate orthopaedic training in Delhi-NCR

“…Institutes and hospitals have re-organised orthopaedic services with cancellation of face to face lectures, clinical rounds, seminars, and similar academic and teaching activities. 6 This has affected post-graduate (PG) teaching and learning in an unprecedented manner. The PG teaching in orthopaedics is going through difficult times during COVID-19 pandemic.…”

Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study

“…2 Alternative measures to maintain follow-up of such patients can reduce the overcrowding in the OPDs and help in the maintenance of physical distancing to prevent disease transmission. 3 Telemedicine is a potential alternative that has already been used for health care services delivery to rural and remote areas with a lack of transport facilities, for those with socioeconomic limitations and vulnerable patients for whom physical follow-up is inconvenient. 4 Telemedicine has been defined by the WHO as the remote delivery of health care services by health care professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment, and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.…”

Restructuring ENT out-patient services during the coronavirus disease 2019 pandemic – an iterative approach

“…To date, minimal literature reporting on out-patient services in the Covid-19 pandemic exists. Lal et al 28 produced recommendations for an orthopaedic out-patient department. They adjusted their clinic set-up with respect to social distancing requirements, and published a floor-plan and patient flow model.…”