One and done? Outcomes from 3961 patients managed via a virtual fracture clinic pathway for paediatric fractures
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Published on: November 8, 2024
Jim Kennedy1, Carol Blackburn2, Michael Barrett2
1Consultant Orthopaedic Surgeon, Dept. of Orthopaedics, Children's Health Ireland at Crumlin, Dublin, D12 N512, Republic of Ireland.
Insights
A virtual fracture clinic pathway for pediatric trauma is safe and effective. This model significantly reduced costs and improved patient outcomes, with most children being discharged without needing in-person follow-up.
Area of Science:
- Paediatric Orthopaedics
- Trauma Management
- Healthcare Innovation
Background:
- Minor paediatric trauma often requires clinical assessment.
- Traditional fracture clinics can lead to long waiting times and increased healthcare costs.
- Virtual fracture clinics offer a potential solution for efficient management.
Purpose of the Study:
- To evaluate the experience and outcomes of a virtual fracture clinic pathway for paediatric trauma.
- To assess the safety, effectiveness, and cost-efficiency of this innovative approach.
Main Methods:
- Prospective data collection of patients referred from the Paediatric Emergency Department (PED) to the virtual fracture clinic.
- Analysis of patient outcomes including discharge rates, referrals for operative treatment, and unplanned re-presentations.
- Cost analysis using established costing for virtual fracture clinics within the Irish Healthcare System.
Main Results:
- 3961 patients were referred to the virtual fracture clinic; 70% were discharged.
- 26% of patients required a face-to-face appointment, and only 7.5% of discharged patients needed unplanned follow-up.
- The virtual fracture clinic model generated significant cost savings of €254,120.
Conclusions:
- The virtual fracture clinic pathway is a safe and effective method for managing minor paediatric trauma.
- This model offers substantial cost savings for the healthcare system.
- Virtual fracture clinics represent a valuable advancement in paediatric trauma care.
Purpose:
The aim of this paper is to describe our experience with a virtual fracture management pathway in the setting of a paediatric trauma service.
Methods:
All patients referred to the virtual fracture clinic service from the Paediatric Emergency Department (PED) were prospectively collected. Outcome data of interest (patients discharged, referred for urgent operative treatment, referred back to emergency department for further evaluation, referred for face-to-face clinical assessment and all patients who re-presented on an unplanned basis for further management of the index injury) were compiled and collated. Cost analysis was performed using established costing for a virtual fracture clinic within the Irish Healthcare System.
Results:
There were a total of 3961 patients referred to the virtual fracture clinic from the PED. Of these, 70% (n = 2776) were discharged. In all, 26% (n = 1033) were referred to a face-to-face appointment. Of discharged patients, 7.5% (n = 207) required an unplanned face-to-face evaluation. A total of 0.1% (n = 3) subsequently required operative treatment relating to their index injury. Implementation of the virtual fracture clinic model generated calculated savings of €254 120.
Conclusion:
This prospective evaluation has demonstrated that a virtual fracture clinic pathway for minor paediatric trauma is safe, effective and brings significant cost savings.
Level Of Evidence:
II.
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Assessment:
1. Clinical Evaluation:
History: