Telephone clinics for follow-up in hand surgery: an effective model after COVID-19?

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Authors
Hendrickson, SA
Witt, P
Watts, A
Journal
The Bulletin of the Royal College of Surgeons of England
Type
Journal Article
Publisher
Royal College of Surgeons
Rights
© 2021 The Royal College of Surgeons of England
IntroductionTelephone clinics were adopted for follow-up appointments in our plastic hand surgery department during the COVID-19 pandemic. They may pose advantages in cost, efficiency and environmental impact compared with face-to-face consultations. The aim of this study was to assess the success rate of telephone clinics in hand surgery to determine benefit of continuing the practice. MethodsA prospective cohort study of all hand surgery follow-up telephone clinics was conducted over a six-week period. The primary outcome measure was success of the consultation, defined as achieving the same outcome as could have been achieved in a face-to-face clinic. Secondary outcome measures included duration and environmental impact. ResultsDuring the study period, 177 consultations were scheduled. Twenty-nine patients (16%) were not contactable. Of the remaining 148 consultations, 111 (75%) had a successful outcome. The highest success rate (85%) was achieved for first postoperative consultations when the patient had already received hand therapy. On average, consultations lasted 8 minutes but required an additional 16 minutes of preparation, documentation and administrative work. An estimated 5,939km of patient travel (1.25 tonnes of carbon dioxide emissions) were saved during the study period. ConclusionsThe rate of successful outcomes following telephone consultation in our cohort of patients was lower than for face-to-face clinics. However, the service was set up with little time for preparation. The success rate and duration could be improved with appropriate patient selection, especially for those who have undergone straightforward operative procedures. The duration of consultations and the ‘did not attend’ rate should reduce as administrative processes improve.
Citation
Hendrickson, S., Witt, P. and Watts, A. (2021) 'Telephone clinics for follow-up in hand surgery: an effective model after COVID-19?', The Bulletin of the Royal College of Surgeons of England, 103(5), pp. 258-262.
Note
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