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

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 coro...

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Autores principales: Rhind, John-Henry, Ramhamadany, Eamon, Collins, Ruaraidh, Govilkar, Siddharth, Dass, Debashis, Hay, Stuart
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407867/
https://www.ncbi.nlm.nih.gov/pubmed/32818071
http://dx.doi.org/10.1302/2058-5241.5.200041
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author Rhind, John-Henry
Ramhamadany, Eamon
Collins, Ruaraidh
Govilkar, Siddharth
Dass, Debashis
Hay, Stuart
author_facet Rhind, John-Henry
Ramhamadany, Eamon
Collins, Ruaraidh
Govilkar, Siddharth
Dass, Debashis
Hay, Stuart
author_sort Rhind, John-Henry
collection PubMed
description 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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spelling pubmed-74078672020-08-17 An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis Rhind, John-Henry Ramhamadany, Eamon Collins, Ruaraidh Govilkar, Siddharth Dass, Debashis Hay, Stuart EFORT Open Rev General Orthopaedics 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 British Editorial Society of Bone and Joint Surgery 2020-08-01 /pmc/articles/PMC7407867/ /pubmed/32818071 http://dx.doi.org/10.1302/2058-5241.5.200041 Text en © 2020 The author(s) https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle General Orthopaedics
Rhind, John-Henry
Ramhamadany, Eamon
Collins, Ruaraidh
Govilkar, Siddharth
Dass, Debashis
Hay, Stuart
An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis
title An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis
title_full An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis
title_fullStr An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis
title_full_unstemmed An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis
title_short An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis
title_sort analysis of virtual fracture clinics in orthopaedic trauma in the uk during the coronavirus crisis
topic General Orthopaedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407867/
https://www.ncbi.nlm.nih.gov/pubmed/32818071
http://dx.doi.org/10.1302/2058-5241.5.200041
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