The role of the virtual fracture clinic in the management of foot and ankle fractures: a review of patient outcomes and satisfaction

D. Hawarden, M. Boyle, A. Robinson, N. Vasukutty, M. Ballal, A. Pillai

Background: Most patients presenting to the emergency department with foot and ankle injuries can be managed as outpatients. Virtual fracture clinics (VFC) are becoming increasingly popular and help reduce the workload on outpatient clinics. Our study aimed to assess patient outcomes and satisfaction after discharge from a virtual fracture clinic without a face-to-face follow up.

Patients and methods: 200 patients with foot and ankle injuries referred to the virtual fracture clinic over a period of 4 months from October 2015 to January 2016 were reviewed. Data regarding the number of subsequent clinic appointments was collected for both patients discharged from the VFC and those that were referred for follow up. Radiographs for both these groups of patients were reviewed. A telephone survey was conducted on 33 patients to assess their satisfaction.

Results: 82 (41%) patients were discharged from the virtual fracture clinic without follow up. Of these, 4 (4.87%) patients needed to return to the clinic for further appointments and 6 (7.32%) required repeat imaging. Out of the 33 patients surveyed 94% rated the service as good or excellent and 97% said they would be likely or extremely likely to recommend the service to a family member or friend.

Conclusions: The virtual fracture clinic in our institution is safe and effective with high patient satisfaction. Discharged patients have good outcomes with a very low percentage returning to clinic for further review or needing subsequent x-rays. VFC s will help bring down costs and improve the efficiency of our fracture clinics without compromising quality of care and maintaining high patient satisfaction rates.