Service reconfiguration in the department of hand surgery during the UK COVID-19 lockdown: Birmingham experience

Abstract

In early 2020, the COVID-19 pandemic swept through the UK and had a major impact on healthcare services. The Birmingham hand centre, one of the largest hand trauma units in the country, underwent a dramatic service reconfiguration to enable robust and safe provision of care that would withstand the peak of the pandemic. Streamlining our service significantly reduced patient footfall and hospital admission while preventing intra-hospital viral transmission. Many of the changes implemented have been kept as permanent adjustments to our practice as this new model of care yields higher patient satisfaction and efficacy to withstand the pressures of further peaks in the pandemic.

Strategic planning of plastic surgery emergencies during the COVID-19 pandemic: Lessons learnt from a tertiary plastic surgery centre

“…Emergency referrals to St. George's decreased from 1,070 in 2019 to 692 in 2020. This significant decrease of 35.3% (p<0.01) corresponds to data in other studies 1 , 2 . There was a similar gender distribution in both years.…”

Reconfiguration of Strategy for Hand Surgery during COVID-19 Pandemic: Our Experience

“…The authors found that there was a substantial decrease in patient footfall and hospital admission, thereby eliminating COVID-19 transmission intra-hospital. 9 Similar service reconfiguration has been suggested by Venkatesan et al as well who have suggested the use of Mini C arm and WALANT in hand surgery cases. 10 Our experience of adherence to the WALANT technique for hand surgery has been recommended in the pandemic.…”

One Year of COVID-19: Lessons Learned in a Hand Trauma Center

“…Other changes were brought, including the use of absorbable skin sutures and less frequent check-ups with patients when possible. Additionally, Atia et al [17] described checking up on patients less frequently, whereas most of authors used telemedicine to follow up with their patients [12,14,[22][23][24]. This is a method that proved its accuracy [25] and found satisfaction among patients [10,22,26], whereas surgeons had frequent issues [10,22].…”

“…The authors did not use telemedicine, and Toia et al [11] as well as Leti Acciaro et al [27] confirmed it might be an issue in Italy. To reduce contamination risks [28], some surgeons increased non-surgical treatment [9,23], and to resolve issues linked to a diminution of anesthetists' availability, many hand surgeons [9,12,14,17,24,29] stated to use WALANT surgery [30].…”