Article ; Online: The impact of digitisation of a virtual fracture clinic on referral quality, outcomes and assessment times.
2021 Volume 48, Issue 2, Page(s) 1327–1334
Abstract: Background: Virtual fracture clinics (VFCs) have become widely adopted, aiming to improve efficiency, standardise patient care and reduce clinic appointments for injuries that can be managed conservatively. A variety of means exist to manage VFC ... ...
| Abstract | Background: Virtual fracture clinics (VFCs) have become widely adopted, aiming to improve efficiency, standardise patient care and reduce clinic appointments for injuries that can be managed conservatively. A variety of means exist to manage VFC referrals and assessment, including paper-based and digital methods. This study assesses VFC referral quality and outcomes before and after implementation of a digital VFC referral and management system. Methods: A retrospective analysis was conducted of all VFC referrals and assessments from July 2017-March 2020 in a large UK district general hospital. All referrals and assessments were analysed for quality and completeness of referral information, grade of assessor, outcome of assessment, referral-to-assessment time, and assessment-to-surgery time (for those requiring operative management). Results: 3038 paper and 9,228 digital referrals were analysed by 2 separate reviewers. Quality and completeness of referral information showed significant improvement in 11 predetermined key data points with the digital referral system (p < 0.001). Date and mechanism of injury were the most commonly missing data criteria (67.5% and 68.2%, respectively) with paper referrals. Significant improvements were noted in the proportion of Consultant delivered VFC assessments (84.2% vs 71.0%; p < 0.001), VFC discharge rate (20.8% vs 13.1%; p < 0.001) and patients recalled for urgent review (6.2% vs 0.8%; p < 0.001) with digital referrals. Mean referral-to-assessment (31.2 vs 49.9 h; p < 0.001) and assessment-to-surgery (9.2 vs 13.0 days; p = 0.01) times also reduced significantly with referral digitisation. Conclusion: Improvements in virtual referral quality and completeness directly lead to facilitation of more thorough, detailed and appropriate virtual assessments; improving timely decision-making, reducing unnecessary appointments, and permitting better prioritisation of workload and earlier surgery for patients requiring operative treatment. Purpose-built digital solutions are an excellent means of achieving these aims. |
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| MeSH term(s) | Ambulatory Care Facilities ; Consultants ; Fractures, Bone/surgery ; Humans ; Referral and Consultation ; Retrospective Studies | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-04-09 | ||||||||||
| Publishing country | Germany | ||||||||||
| Document type | Journal Article | ||||||||||
| ZDB-ID | 2275480-5 | ||||||||||
| ISSN | 1863-9941 ; 1863-9933 | ||||||||||
| ISSN (online) | 1863-9941 | ||||||||||
| ISSN | 1863-9933 | ||||||||||
| DOI | 10.1007/s00068-021-01661-9 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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