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Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures

Anne-Marie Hutchison, Owen Bodger Orcid Logo, Rhys Whelan Orcid Logo, I. Dougie Russell, Wing Man, Paul Williams, Andrew Bebbington

Bone and Joint Open, Volume: 3, Issue: 9, Pages: 726 - 732

Swansea University Author: Owen Bodger Orcid Logo

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DOI (Published version): 10.1302/2633-1462.39.bjo-2022-0077.r1

Abstract

AimsWe introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advic...

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Published in: Bone and Joint Open
ISSN: 2633-1462
Published: British Editorial Society of Bone & Joint Surgery 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa61625
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The patients were asked to complete the Patient-Rated Wrist Evaluation (PRWE), a satisfaction questionnaire, advise if they had required surgery and/or contacted any health professional, and were also asked for any recommendations on how to improve the service. A review with a hand surgeon was organized if required, and a cost analysis was also conducted.ResultsOverall 71/101 patients completed the telephone consultation; no patients required surgery, and the mean and median PRWE scores were 23.9/100 (SD 24.9) and 17.0/100 (interquartile range (IQR) 0 to 40), respectively. Mean patient satisfaction with treatment was 34.3/40 (SD 9.2), and 65 patients (92%) were satisfied or highly satisfied. In total there were 16 contact calls, 12 requests for a consultant review, no formal complaints, and 15 minor adjustment suggestions to improve patient experience. A relationship was found between intra-articular injuries and lower patient satisfaction scores (p = 0.025), however no relationship was found between PRWE scores and the nature of the fracture. Also, no relationship was found between the type of immobilization and the functional outcome or patient satisfaction. Cost analysis of the self-care pathway V traditional pathway showed a cost savings of over £13,500 per year with the new self-care model compared to the traditional model.ConclusionOur study supports a VFC self-care pathway for patients with minimally displaced distal radius fractures. The pathway provides a good level of patient satisfaction and function. 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spelling v2 61625 2022-10-20 Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures 8096440ab42b60a86e6aba678fe2695a 0000-0002-4022-9964 Owen Bodger Owen Bodger true false 2022-10-20 HDAT AimsWe introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advice on exercises and return to function.MethodsAll patients managed via this protocol between March and October 2020 were contacted by a medical secretary at a minimum of six months post-injury. The patients were asked to complete the Patient-Rated Wrist Evaluation (PRWE), a satisfaction questionnaire, advise if they had required surgery and/or contacted any health professional, and were also asked for any recommendations on how to improve the service. A review with a hand surgeon was organized if required, and a cost analysis was also conducted.ResultsOverall 71/101 patients completed the telephone consultation; no patients required surgery, and the mean and median PRWE scores were 23.9/100 (SD 24.9) and 17.0/100 (interquartile range (IQR) 0 to 40), respectively. Mean patient satisfaction with treatment was 34.3/40 (SD 9.2), and 65 patients (92%) were satisfied or highly satisfied. In total there were 16 contact calls, 12 requests for a consultant review, no formal complaints, and 15 minor adjustment suggestions to improve patient experience. A relationship was found between intra-articular injuries and lower patient satisfaction scores (p = 0.025), however no relationship was found between PRWE scores and the nature of the fracture. Also, no relationship was found between the type of immobilization and the functional outcome or patient satisfaction. Cost analysis of the self-care pathway V traditional pathway showed a cost savings of over £13,500 per year with the new self-care model compared to the traditional model.ConclusionOur study supports a VFC self-care pathway for patients with minimally displaced distal radius fractures. The pathway provides a good level of patient satisfaction and function. To improve the service, we will make minor amendments to our patient information sheet. Journal Article Bone and Joint Open 3 9 726 732 British Editorial Society of Bone & Joint Surgery 2633-1462 1 9 2022 2022-09-01 10.1302/2633-1462.39.bjo-2022-0077.r1 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University Another institution paid the OA fee The authors report that they received open access funding for their manuscript from the Bevan Commission. 2024-02-02T08:22:39.2540988 2022-10-20T14:48:24.1289781 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Anne-Marie Hutchison 1 Owen Bodger 0000-0002-4022-9964 2 Rhys Whelan 0000-0001-6722-7726 3 I. Dougie Russell 4 Wing Man 5 Paul Williams 6 Andrew Bebbington 7 61625__25757__3cc5d4632c6e4106a38f4b1efaa7c16f.pdf 61625.pdf 2022-11-14T11:45:16.9810862 Output 321576 application/pdf Version of Record true © 2022 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-­NC-­ND 4.0) licence true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
spellingShingle Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
Owen Bodger
title_short Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
title_full Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
title_fullStr Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
title_full_unstemmed Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
title_sort Functional outcome and patient satisfaction with a ‘self-care’ protocol for minimally displaced distal radius fractures
author_id_str_mv 8096440ab42b60a86e6aba678fe2695a
author_id_fullname_str_mv 8096440ab42b60a86e6aba678fe2695a_***_Owen Bodger
author Owen Bodger
author2 Anne-Marie Hutchison
Owen Bodger
Rhys Whelan
I. Dougie Russell
Wing Man
Paul Williams
Andrew Bebbington
format Journal article
container_title Bone and Joint Open
container_volume 3
container_issue 9
container_start_page 726
publishDate 2022
institution Swansea University
issn 2633-1462
doi_str_mv 10.1302/2633-1462.39.bjo-2022-0077.r1
publisher British Editorial Society of Bone & Joint Surgery
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description AimsWe introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advice on exercises and return to function.MethodsAll patients managed via this protocol between March and October 2020 were contacted by a medical secretary at a minimum of six months post-injury. The patients were asked to complete the Patient-Rated Wrist Evaluation (PRWE), a satisfaction questionnaire, advise if they had required surgery and/or contacted any health professional, and were also asked for any recommendations on how to improve the service. A review with a hand surgeon was organized if required, and a cost analysis was also conducted.ResultsOverall 71/101 patients completed the telephone consultation; no patients required surgery, and the mean and median PRWE scores were 23.9/100 (SD 24.9) and 17.0/100 (interquartile range (IQR) 0 to 40), respectively. Mean patient satisfaction with treatment was 34.3/40 (SD 9.2), and 65 patients (92%) were satisfied or highly satisfied. In total there were 16 contact calls, 12 requests for a consultant review, no formal complaints, and 15 minor adjustment suggestions to improve patient experience. A relationship was found between intra-articular injuries and lower patient satisfaction scores (p = 0.025), however no relationship was found between PRWE scores and the nature of the fracture. Also, no relationship was found between the type of immobilization and the functional outcome or patient satisfaction. Cost analysis of the self-care pathway V traditional pathway showed a cost savings of over £13,500 per year with the new self-care model compared to the traditional model.ConclusionOur study supports a VFC self-care pathway for patients with minimally displaced distal radius fractures. The pathway provides a good level of patient satisfaction and function. To improve the service, we will make minor amendments to our patient information sheet.
published_date 2022-09-01T08:22:39Z
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