Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries
| Autor: | Hardin Pantle, Scott D. Lifchez, Edward S. Bessman, Simon C. Mears |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Subspecialty Fractures Bone Patient satisfaction medicine Back pain Humans Orthopedics and Sports Medicine Musculoskeletal Diseases Child Electronic systems Musculoskeletal System Referral and Consultation Retrospective Studies Patient Care Team business.industry Emergency department medicine.disease Musculoskeletal problems Electronics Medical LUMBAR SPINE FRACTURE Orthopedics Treatment Outcome Orthopedic surgery Surgery Interdisciplinary Communication Medical emergency medicine.symptom business Emergency Service Hospital Delivery of Health Care Specialization |
| Zdroj: | Orthopedics. 38(5) |
| ISSN: | 1938-2367 |
| Popis: | Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors’ institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED. The authors hypothesized that select injuries could be safely managed in the ED by using an electronic system to ensure appropriate follow-up care. Using Kaizen methodology, a multidisciplinary group (including ED staff, orthopedics, plastic surgery, pediatrics, nursing, radiology, therapy, and administration) met to improve care for select musculoskeletal injuries. A system was agreed on in which ED providers managed select musculoskeletal injuries without subspecialist consultation. Follow-up was organized using an electronic system, which facilitated communication between the ED staff and the secretarial staff of the subspecialist departments. Over a 1-year period, 150 patients were treated using this system. Charts and radiographs were reviewed for missed injuries. Radiographic review revealed 2 missed injuries. One patient had additional back pain and a lumbar spine fracture was found during the subspecialist follow-up visit; it was treated nonoperatively. Another patient appeared to have scapholunate widening on the injury radiograph that was not appreciated in the ED. Of the 150 patients, 51 were seen in follow-up by a subspecialist at the authors’ institution. An electronic system to organize follow-up with a subspecialist allowed the ED providers to deliver safe and effective care for simple musculoskeletal injuries. [ Orthopedics. 2015; 38(5):e407–e410.] |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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