The virtual fracture clinic improves quality of care for patients with hand and wrist injuries: an assessment of 3709 patients

Abstract

Fracture clinic services are under significant pressures to meet patients' expectations of a high-quality service. The virtual fracture clinic has shown early promise in helping to reduce such pressures. We used the virtual fracture clinic for hand and wrist injuries treated in the orthopaedic fracture clinic and used key quality indicators to measure improvement. Over the first 21 months, key patient outcome measures and satisfaction scores for patients discharged from the virtual fracture clinic with education to self-care were excellent. Our results show that a virtual fracture clinic model can be applied to provide high-quality care for hand and wrist injuries. The main advantage of the virtual fracture clinic is its ability to direct patients to the right person for timely treatment. We conclude from our 21-month experience that this model of care allows safe, effective, patient-centred, efficient and equitable care to the patients with hand and wrist fractures. Level of evidence: IV

Direct discharge from the emergency department of simple stable injuries: a propensity score-adjusted non-inferiority trial

“…The majority of the studies at an institutional level are non-comparative process evaluations of implementing (parts of) the VFC model. [2][3][4][5][6] These studies typically include relatively large numbers of patients and provide information on the distribution of patients across the VFC model. Data regarding patients' outcomes and experiences typically are limited, and therefore conclusions regarding the safety, effectiveness, and efficacy of DD for each individual injury cannot be drawn.…”

“…Therefore, recently, a Virtual Fracture Clinic (VFC) model was introduced in several hospitals in the UK to optimize and streamline outpatient trauma care. [2][3][4][5][6] The VFC model consists of two main components. 2 4 The first component is direct discharge (DD) from the ED of patients with simple stable injuries (SSIs).…”

“…4 The second component is a 'virtual' review of all other ED patients with musculoskeletal injuries (ie, not discharged directly). [2][3][4][5][6] During this consultant-led VFC review, patients are triaged to an appropriate patient-centered pathway, aiming to reduce unnecessary and untimely follow-up appointments. Typically, DD of SSIs is implemented prior to the implementation of a VFC review.…”

Direct discharge of patients with simple stable musculoskeletal injuries as an alternative to routine follow-up: a systematic review of the current literature

“…Ten studies (38%) compared DD to routine care [8][9][10][11][12][13][14][15][16][17], whereas 16 (62%) studies did not have a control cohort [1,2,[18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Twenty-four studies (92%) were conducted in the UK and two in New Zealand (8%) [25,26].…”

Virtual Clinical Services for Rehabilitation in Hand Surgery

“…2 The coronavirus disease 2019 pandemic has catapulted us into the digital health services era and accelerated the growth of telemedicine, 3 and there has been increased interest in virtual clinical services for hand surgery. 4 However, both articles fall short in elaborating the use of digital technology for physical and occupational therapy in hand surgery. This letter aims to highlight the potential of virtual clinical services to complement rehabilitation in hand surgery, while acknowledging its limitations.Virtual services in rehabilitation were previously found to be effective.…”