Evidence map›Paper›PMID 33837452›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022

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

Benjamin M Sephton, Hannah Morley, Piyush Mahapatra, Michael Shenouda, Mustafa Al-Yaseen, Darryl E Bernstein, George Cross, Daniel E Dalili, Amrit Gurung, Atul Kamat and 6 more

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Benjamin M SephtonDepartment of Trauma and Orthopaedics, Wythenshawe Hospital, University Hospital of South Manchester NHS Trust, Manchester, M23 9LT, UK. b.sephton@nhs.net.ORCID http://orcid.org/0000-0002-8058-168X
Hannah MorleyDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Piyush MahapatraDepartment of Trauma and Orthopaedics, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, W6 8RF, UK.
Michael ShenoudaDepartment of Trauma and Orthopaedics, Hillingdon Hospital, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UB8 3NN, UK.
Mustafa Al-YaseenDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Darryl E BernsteinDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
George CrossDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Daniel E DaliliDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Amrit GurungDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Atul KamatDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Andrew J KucDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Aisha R MohammedDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Mehreen ParaoutyDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Amsanaa PonniahDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Ben SluckisDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.
Krisztian DeierlDepartment of Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, WD18 0HB, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVirtual 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.

methodsA 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).

results3038 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.

conclusionImprovements 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.

Indexed as

Fractures, BoneAmbulatory Care FacilitiesConsultantsHumansReferral and ConsultationRetrospective StudiesDigitalisationDigitisationOrthopaedicsTraumaVirtual fracture clinic

Identifiers

PMID33837452

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.