Virtual fracture clinic management of fifth metatarsal, including Jones’, fractures is safe and cost-effective

Brogan, Kit; Bellringer, Simon; Akehurst, Harold; Gee, Christopher; Ibrahim, Nada; Cassidy, Lucy; Rogers, Benedict D.; Gibbs, James

doi:10.1016/j.injury.2017.02.003

Cited by 49 publications

(43 citation statements)

References 12 publications

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“…Mason type I and II fractures of the radial head and neck, extra-articular fractures of the little finger metacarpal and any fracture of the fifth metatarsal were considered appropriate for such direct discharge to self-management. Despite positive patient reported outcomes and efficiency savings through the employment of a VFC system 3,6,7 , concerns remain regarding the deviation from the BOAST 7 guideline published by the British Orthopaedic Association, which states that all new referrals should be seen in a fracture clinic within 72 hours 8 .…”

Section: Introductionmentioning

confidence: 99%

Discharged but not dissatisfied: outcomes and satisfaction of patients discharged from the Edinburgh Trauma Triage Clinic

Mackenzie

Carter

Jefferies

et al. 2018

The Bone & Joint Journal

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Section: Introductionmentioning

confidence: 99%

Discharged but not dissatisfied: outcomes and satisfaction of patients discharged from the Edinburgh Trauma Triage Clinic

Mackenzie

Carter

Jefferies

et al. 2018

The Bone & Joint Journal

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“…There is good evidence that fifth metatarsal fractures maybe managed through a VFC model. 44 , 45 Ferguson et al showed that fifth metatarsal fractures could be managed effectively at first contact in the ED without further follow up. 39 Other injuries that have been shown to be effectively managed through a VFC model are: fifth metacarpal fractures, 40 clavicle fractures, 46 mallet finger injuries, 41 ankle fractures 47 and paediatric fractures.…”

Section: Clinical Efficiencymentioning

confidence: 99%

An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis

et al. 2020

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Virtual fracture clinics (VFC) are advocated by new orthopaedic (British Orthopaedic Association) and National Health Service (NHS) guidelines in the United Kingdom. We discuss benefits and limitations, reviewing the literature, as well as recommendations on introducing a VFC service during the coronavirus pandemic and into the future. A narrative review identifying current literature on virtual fracture clinic outcomes when compared to traditional model fracture clinics in the UK. We identify nine relevant publications related to VFC. The Glasgow model, initiated in 2011, has become the benchmark. Clinical efficiency can be improved, reducing the number of emergency department (ED) referrals seen in VFC by 15–28% and face-to-face consultations by 65%. After review in the VFC, 33–60% of patients may be discharged. Some studies have shown no negative impact on the ED; the time to discharge was not increased. Patient satisfaction ranges from 91–97% using a VFC service, and there may be cost-saving benefits annually of £67,385 to £212,705. Non-attendance may be reduced by 75% and there are educational opportunities for trainees. However, evidence is limited; 28% of patients prefer face-to-face consultations and not all have access to internet or email (72%). We propose a pathway integrating the VFC model, whilst having senior orthopaedic decision makers available in the ED, during normal working hours, to cope with the pandemic. Beyond the pandemic, evidence suggests the Glasgow model is viable for day-to-day practice. Cite this article: EFORT Open Rev 2020;5:442-448. DOI: 10.1302/2058-5241.5.200041

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“…The virtual clinic model is increasingly being adopted by various medical and surgical specialities and has revealed both a safe and cost-effective patient pathway associated with high patient satisfaction rates and patient reported outcomes. [1][2][3][4][5][6][7][8] The redesign and reconfiguration of the traditional "face to face" fracture clinic model towards virtual assessment and management of patients has been shown in some studies to equate to a saving of almost 40% in direct costs. [8][9][10][11] While indirect costs are more difficult to accurately determine, some stud-ies have cited approximately €80 per consultation as a cost to society, because of a reduction in productivity, as well as equating to nearly half a day of school lost with regard to paediatric fracture clinic appointments.…”

Section: Introductionmentioning

confidence: 99%

A national virtual fracture clinic service: A more tactful approach

Reilly¹

2020

IJOTSS

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Introduction: The redesign and reconfiguration of the traditional "face to face" fracture clinic model towards virtual assessment and management of patients has been shown to be safe, cost-effective and associated with high patient satisfaction and patient reported outcome rates. The purpose of this study was to look at the potential financial implications of introducing a national virtual fracture clinic service in Ireland. Methods: A combination of established costings for a virtual fracture clinic pathway at our institution and current available public data was utilised to create a national projection. Results: The introduction of a national TAC service could lead to areduction of 31.5% of patients attending traditional "face to face" fracture clinic appointments with a further 35% of this cohort being discharged directly representing an overall projected cost saving per annum in excess of €3.3 million. Conclusion: The introduction of a national TAC service would promote patient empowerment without comprising clinical care and could provide significant cost savings and financial benefits for the Irish Public Health System without the need for substantial investment.

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Virtual fracture clinic management of fifth metatarsal, including Jones’, fractures is safe and cost-effective

Cited by 49 publications

References 12 publications

Discharged but not dissatisfied: outcomes and satisfaction of patients discharged from the Edinburgh Trauma Triage Clinic

Discharged but not dissatisfied: outcomes and satisfaction of patients discharged from the Edinburgh Trauma Triage Clinic

An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis

A national virtual fracture clinic service: A more tactful approach

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