Validation of the Primary Care Pathway Model for Management of Orthopedic Injuries: Results of a Prospective, Queensland Study.
J Prim Care Community Health 2020;
11:2150132720967228. [PMID:
33106089 PMCID:
PMC7786413 DOI:
10.1177/2150132720967228]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective:
A “virtual fracture clinic” (VFC) is viewed as a safe, cost effective method of managing suitable low risk orthopedic injuries without direct orthopedic review. This method is used throughout the Glasgow Royal Infirmary (GRI) and National Health System (NHS) as a cornerstone for efficient patient care. This study assessed the outcomes of a newly implemented Queensland based Primary Care Pathway (PCP) for management of simple orthopedic injuries.
Methods:
A prospective cohort was formed of patients presenting over a 4-week period with an acute orthopedic injury to either the Emergency Department (ED) or Primary Care Providers within the Logan Hospital catchment in Queensland, Australia. Patients were triaged to either a PCP management protocol with General Practitioners (GP), Allied-Health Professionals (AHP) or to a traditional in-person Fracture Clinic (FC) orthopedic review. Patients were followed for 6-months. Data were collected about epidemiology, complications, appropriate allocation, and injury type.
Results:
A total of 1283 patients were referred over the study period, of which 267 were triaged to PCP management. ED referrals accounted for 62.5% of appropriate referrals to either clinic. Upper limb injuries were the most common conditions managed through the PCP. Patients managed by the PCP model of care experienced a 4.29% complication rate over the 6-month follow-up period.
Conclusion:
The PCP model of care is effective in managing criteria specific, low risk orthopedic injuries with a low rate of complications (4.29%) without direct orthopedic FC review. Use of a PCP reduces demand on hospital resources, and provides a safe, cost-effective alternative to a resource-restricted outpatient service.
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