AB098. SOH21AS169. Upscaling virtual fracture clinic use is a safe, effective measure in the delivery of trauma care

Background: The virtual fracture clinic (VFC) has proved beneficial in reducing footfall within the hospital setting, improving the cost of running a trauma service, whilst satisfying the vast majority of referred patients. The mandatory upscaling of telemedicine use, specifically the enhancement of the VFC, amidst the coronavirus disease 2019 (COVID-19) pandemic, was analysed.

Methods: The remit of the VFC within our hospital has been expanded so as to include all referred ambulatory trauma. Outcomes of our VFC review over the six-week period following the introduction of the national Irish COVID-19 related restrictions were gathered. These outcomes were analysed and compared to the corresponding six-week period from 2019.

Results: A 77.2% increase in the VFC referral volume was observed throughout the COVID-19 related time period. Patients were directly discharged in 55.2% of cases in 2020, as opposed to 47.8% in 2019 (P=0.044); referred directly for physiotherapy in 32.9% of cases in 2020, as opposed to 28.9% in 2019 (P=0.173); and referred to a fracture clinic in 11.9% of cases in 2020, as opposed to 23.7% in 2019 (P<0.001). Three percent of patients returned to the clinic post discharge in 2020, compared to 4.4% in 2019 (P=0.237). 4.5% of patients were referred for surgery in 2020, as opposed to 2.2% in 2019 (P=0.105).

Conclusions: The VFC proved to be an efficient tool in managing ambulatory trauma throughout the pandemic. Upscaling the VFC to include all ambulatory trauma is a safe, effective method in reducing clinic attendances and hospital footfall, whilst ensuring high care standards are maintained.

Keywords: Virtual fracture clinic (VFC); practice management; service provision; quality improvement; fracture clinic; coronavirus disease 2019 (COVID-19)