Determining the appropriate use of Technology Enabled Care Services (TECS) to manage upper-limb trauma injuries during the COVID-19 pandemic: A multicentre retrospective observational study.


Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
07 2022
Historique:
received: 18 05 2021
accepted: 14 02 2022
pubmed: 4 4 2022
medline: 14 7 2022
entrez: 3 4 2022
Statut: ppublish

Résumé

The COVID-19 pandemic created a unique opportunity to explore the use of Technology Enabled Care Services (TECS), which remains novel for many service providers. This study assesses the factors that affect adaptation to remote monitoring of patients after upper-limb trauma injury. A standardised risk-stratified screening tool is further developed here to support clinical staff in both the determination of appropriate use of TECS and the optimisation of patient care. 1: To explore the patient and injury factors that determine the appropriate use of TECS for patients with upper-limb injury. 2: To use these findings to refine a standardised screening tool for the appropriate choice of follow-up format. A retrospective review of patient management was undertaken across three NHS upper-limb trauma units during the first UK COVID-19 lockdown. Data were collected, and themes were analysed across a number of predetermined categories. This was underpinned by a review of contemporary policy guidance and literature. A total of 85% of patients were offered an appropriate format of follow-up; this was defined by the ability to achieve desired patient-clinician goals and lack of complications. Key factors in determining appropriate follow-up included extent of injury, mental health considerations, and the need for face-to-face (F2F) assessment and treatment. Study findings demonstrate consistency between units in the factors determining the appropriate use of TECS. The refined screening tool provides a risk-stratified, standardised approach to the choice of follow-up format, F2F or TECS. It is hoped that this will support future clinical decision-making processes to ensure optimal patient care.

Sections du résumé

BACKGROUND
The COVID-19 pandemic created a unique opportunity to explore the use of Technology Enabled Care Services (TECS), which remains novel for many service providers. This study assesses the factors that affect adaptation to remote monitoring of patients after upper-limb trauma injury. A standardised risk-stratified screening tool is further developed here to support clinical staff in both the determination of appropriate use of TECS and the optimisation of patient care.
OBJECTIVES
1: To explore the patient and injury factors that determine the appropriate use of TECS for patients with upper-limb injury. 2: To use these findings to refine a standardised screening tool for the appropriate choice of follow-up format.
METHODS
A retrospective review of patient management was undertaken across three NHS upper-limb trauma units during the first UK COVID-19 lockdown. Data were collected, and themes were analysed across a number of predetermined categories. This was underpinned by a review of contemporary policy guidance and literature.
RESULTS
A total of 85% of patients were offered an appropriate format of follow-up; this was defined by the ability to achieve desired patient-clinician goals and lack of complications. Key factors in determining appropriate follow-up included extent of injury, mental health considerations, and the need for face-to-face (F2F) assessment and treatment.
CONCLUSION
Study findings demonstrate consistency between units in the factors determining the appropriate use of TECS. The refined screening tool provides a risk-stratified, standardised approach to the choice of follow-up format, F2F or TECS. It is hoped that this will support future clinical decision-making processes to ensure optimal patient care.

Identifiants

pubmed: 35367161
pii: S1748-6815(22)00072-9
doi: 10.1016/j.bjps.2022.02.003
pmc: PMC8855640
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

2127-2134

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Références

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pubmed: 31213166

Auteurs

L Sayed (L)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK. Electronic address: lsayed@doctors.org.uk.

P Valand (P)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK.

M P Brewin (MP)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK.

A Matthews (A)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK.

M Robson (M)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK.

N Nayaran (N)

Burns & Plastics Department, Oxford University Hospitals, Headley Way, Headington, Oxford OX3 9DU, UK.

A Alexander (A)

Burns & Plastics Department, Oxford University Hospitals, Headley Way, Headington, Oxford OX3 9DU, UK.

L Davies (L)

Burns & Plastics Department, Oxford University Hospitals, Headley Way, Headington, Oxford OX3 9DU, UK.

E Scott (E)

Hand Surgery Unit, Royal Cornwall Hospitals, Treliske, Truro, Cornwall, TR1 3LJ, UK.

J Steele (J)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK.

E McMullen (E)

Burns & Plastics Department, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK.

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Classifications MeSH