The clinical and cost effectiveness of a virtual fracture clinic service

McKirdy, Anne; Imbuldeniya, Arjuna

doi:10.1302/2046-3758.65.bjr-2017-0330.r1

Cited by 69 publications

(42 citation statements)

References 16 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been shown in the literature that the immediate effect of an implemented VFC service is a reduction in the number of ED to fracture clinic referrals by between 15% and 28%. 15 , 17 , 43 Additionally, 55–67% of ED referrals that would have been seen in a traditional fracture clinic, were appropriate to be seen in the VFC. 11 , 21 Anderson et al showed a 65% reduction in face-to-face consultations in a fully implemented VFC service.…”

Section: Clinical Efficiencymentioning

confidence: 99%

“…The overall discharge rate after review in the VFC ranges greatly from 33% to 60% 11 , 17 , 19 who did not require any formal fracture clinic appointment or further review. The percentage of patients meeting the BOAST 7 guideline (seen within 72 hours in clinic from the ED), ranges from 46% 17 to 100% 22 in the literature. During the current coronavirus pandemic, timely decision making and intervention are key.…”

Section: Clinical Efficiencymentioning

confidence: 99%

“…This has also increased the time clinicians can dedicate to patients within the VFC and has shown increased time per patient. 17 In addition to clinicians, it has been shown to increase time per patient for the nurses, administration staff and typists within fracture clinic services. 16 With fewer referrals to face-to-face fracture clinics and improved waiting times from referral to first orthopaedic review in clinic, this ensures more timely management decisions are made.…”

Section: Clinical Efficiencymentioning

confidence: 99%

“… 16 With fewer referrals to face-to-face fracture clinics and improved waiting times from referral to first orthopaedic review in clinic, this ensures more timely management decisions are made. 17 At a service level, significant benefit was derived from freeing up clinical and administrative time. 11 This is particularly important during the COVID-19 pandemic where as much as possible should be done to make healthcare professionals’ daily work more time efficient.…”

Section: Clinical Efficiencymentioning

confidence: 99%

“…The annual reported yearly savings from implementing a full VFC service, when compared to a traditional model, vary from £67,385 to £212,705 in the literature. 11 , 15 , 17 Anderson et al calculated the cost per patient was reduced from £36 to £22 16 and O’Reilly et al calculated the cost decreased from €129 to €28. 19 Jenkins et al predicted that national adoption of the redesigned fracture pathway may have resulted in a cost saving of £3,535,808 over the time period (2009–2014).…”

Section: Cost Savingsmentioning

confidence: 99%

See 4 more Smart Citations

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

et al. 2020

View full text Add to dashboard Cite

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

show abstract

Section: Clinical Efficiencymentioning

confidence: 99%

Section: Clinical Efficiencymentioning

confidence: 99%

Section: Clinical Efficiencymentioning

confidence: 99%

Section: Clinical Efficiencymentioning

confidence: 99%

Section: Cost Savingsmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2020

View full text Add to dashboard Cite

show abstract

The impact of digitisation of a virtual fracture clinic on referral quality, outcomes and assessment times

Sephton

Morley

Mahapatra

et al. 2021

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Healthcare utilization and satisfaction with treatment before and after direct discharge from the Emergency Department of simple stable musculoskeletal injuries in the Netherlands

Geerdink

Spierings

Schuijt

et al. 2022

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose To evaluate healthcare utilization and satisfaction with treatment before and after implementing direct discharge (DD) from the Emergency Department (ED) of patients with simple, stable musculoskeletal injuries. Methods Patients with simple, stable musculoskeletal injuries were included in two Dutch hospitals, both level-2 trauma centers: OLVG and Sint Antonius (SA), before (pre-DD-cohort) and after implementing DD (DD-cohort). With DD, no routine follow-up appointments are scheduled after the ED visit, supported by information leaflets, a smartphone application and a telephone helpline. Outcomes included: secondary healthcare utilization (follow-up appointments and X-ray/CT/MRI); satisfaction with treatment (scale 1–10); primary healthcare utilization (general practitioner (GP) or physiotherapist visited, yes/no). Linear regression was used to compare secondary healthcare utilization for all patients and per injury subgroup. Satisfaction and primary healthcare utilization were analyzed descriptively. Results A total of 2033 (OLVG = 1686; SA = 347) and 1616 (OLVG = 1396; SA = 220) patients were included in the pre-DD-cohort and DD-cohort, respectively. After DD, the mean number of follow-up appointments per patient reduced by 1.06 (1.13–0.99; p < 0.001) in OLVG and 1.07 (1.02–0.93; p < 0.001) in SA. Follow-up appointments reduced significantly for all injury subgroups. Mean number of follow-up X-rays per patient reduced by 0.17 in OLVG ( p < 0.001) and 0.18 in SA ( p < 0.001). Numbers of CT/MRI scans were low and comparable. In OLVG, mean satisfaction with treatment was 8.1 (pre-DD-cohort) versus 7.95 (DD-cohort), versus 7.75 in SA (DD-cohort only). In OLVG, 23.6% of pre-DD-cohort patients visited their GP, versus 26.1% in the DD-cohort, versus 13.3% in SA (DD-cohort only). Physiotherapist use was comparable. Conclusion This study performed in a large population and additional hospital confirms earlier pilot results, i.e., that DD has the potential to effectively reduce healthcare utilization, while maintaining high levels of satisfaction. Level of evidence II. Supplementary Information The online version contains supplementary material available at 10.1007/s00068-021-01835-5.

show abstract

The clinical and cost effectiveness of a virtual fracture clinic service

Cited by 69 publications

References 16 publications

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

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

The impact of digitisation of a virtual fracture clinic on referral quality, outcomes and assessment times

Healthcare utilization and satisfaction with treatment before and after direct discharge from the Emergency Department of simple stable musculoskeletal injuries in the Netherlands

Contact Info

Product

Resources

About