Efficiency of a virtual fracture care protocol in non-operative treatment of adult patients with a distal radial fracture

Willinge, Gijs J. A.; Spierings, Jelle F.; Weert, Ton; Twigt, Bas A.; Goslings, J. Carel; van Veen, Ruben N.

doi:10.1177/17531934231187830

Cited by 5 publications

(1 citation statement)

References 32 publications

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“…As our study's observed results are greater than just a shift to remote care, we believe these stem from aspects unaffected by the pandemic, such as organized supervision, multidisciplinary planning, and treatment uniformity. Additionally, a prior study comparing a similar VFC review workflow to pre-VFC treatment during the same COVID period in two hospital sites yielded positive results favoring the VFC review, reinforcing the attribution of outcomes to the VFC review workflow ( 42 ). Finally, the reduction of follow-up appointments, improved allocation of tasks and shift to remote care following VFC review suggests a concomitant cost reduction.…”

Section: Discussionmentioning

confidence: 75%

The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring semi-acute surgery: a retrospective cohort study

Willinge,

Spierings,

Geerdink

et al. 2024

Front. Digit. Health

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PurposeThe demand for trauma care in the Netherlands is increasing due to a rising incidence of injuries. To provide adequate trauma care amidst this increasing pressure, a Virtual Fracture Care (VFC) review protocol was introduced for treatment of musculoskeletal injuries to the extremities (MIE). This study aimed to assess the influence of the Dutch VFC review protocol on secondary healthcare utilization (i.e., follow-up appointments and imaging) in adult trauma patients (aged ≥18 years) who underwent semi-acute surgery (2–14 days after initial presentation) for MIE, compared to traditional workflows. We hypothesized utilization of VFC review would lead to reduced secondary healthcare utilization.MethodsThis retrospective cohort study assessed the influence of VFC review on secondary healthcare utilization in adult trauma patients (aged ≥18 years) who underwent semi-acute surgery for a MIE. Patients treated before VFC review and the COVID-19 pandemic, from 1st of July 2018 to 31st of December 2019, formed a pre-VFC group. Patients treated after VFC review implementation from January 1st 2021 to June 30th 2022, partially during and after the COVID-19 pandemic (including distancing measures), formed a VFC group. Outcomes were follow-up appointments, radiographic imaging, time to surgery, emergency department reattendances, and complications. The study was approved by the local ethical research committee approved this study (WO 23.073).ResultsIn total, 2,682 patients were included, consisting of 1,277 pre-VFC patients, and 1,405 VFC patients. Following VFC review, the total number of follow-up appointments reduced by 21% and a shift from face-to-face towards telephone consultations occurred with 19% of follow-up appointments performed by telephone in the VFC group vs. 4% in the pre-VFC group. Additionally, VFC review resulted in a 7% reduction of radiographs, improved time scheduling of surgery, and a 56% reduction of emergency department reattendances. Registered complication rates remained similar.ConclusionThe utilization of VFC review for management of adult patients with a MIE requiring semi-acute surgery improves efficiency compared to traditional workflows. It results in a 21% follow-up appointment reduction, a shift from face-to-face to remote delivery of care, fewer radiographs, improved time scheduling of surgery, and reduces emergency department reattendances by 56%.

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Section: Discussionmentioning

confidence: 75%

The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring semi-acute surgery: a retrospective cohort study

Willinge,

Spierings,

Geerdink

et al. 2024

Front. Digit. Health

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The Value of Routine Radiography in the Nonoperative Treatment of Metatarsal Fractures: A Retrospective Cohort Study

Willinge,

Boulidam,

Salentijn

et al. 2024

The Journal of Foot and Ankle Surgery

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The impact on time between injury and semi-acute surgery for hand fractures after virtual fracture clinic implementation

Salentijn,

Willinge,

Dijkgraaf

et al. 2024

J Hand Surg Eur Vol

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The aim of this before-and-after study was to evaluate the implementation of a virtual fracture clinic (VFC) on the time between injury and surgery in patients presenting with a phalangeal or metacarpal fracture and in need of semi-acute surgical treatment. Between 1 January and 30 September 2018 (pre-VFC) and in the same period in 2022 (VFC), 101 and 113 patients were included, respectively. Before VCF implementation, the time between injury and surgery was 8.9 days (95% confidence interval [CI]: 8.1 to 9.6), while after VCF implementation it was 7.6 days (95% CI: 7.0 to 8.3). In 2018, 7% of operations were unacceptably delayed beyond 14 days from injury, which was reduced to 5% in 2022, despite patient-presentation delays of up to 10 days. VFC implementation was associated with a reduction in time until semi-acute surgery for phalangeal or metacarpal fractures and improved the quality of semi-acute surgery planning. Level of evidence: Level III

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Efficiency of a virtual fracture care protocol in non-operative treatment of adult patients with a distal radial fracture

Cited by 5 publications

References 32 publications

The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring semi-acute surgery: a retrospective cohort study

The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring semi-acute surgery: a retrospective cohort study

The Value of Routine Radiography in the Nonoperative Treatment of Metatarsal Fractures: A Retrospective Cohort Study

The impact on time between injury and semi-acute surgery for hand fractures after virtual fracture clinic implementation

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