Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2021; 12(1): 24-34
Published online Jan 18, 2021. doi: 10.5312/wjo.v12.i1.24
Hello, can you hear me? Orthopaedic clinic telephone consultations in the COVID-19 era- a patient and clinician perspective
Anuhya Vusirikala, David Ensor, Ajay K Asokan, Alvin JX Lee, Ravi Ray, Dimitrios Tsekes, John Edwin
Anuhya Vusirikala, David Ensor, Ajay K Asokan, Ravi Ray, Dimitrios Tsekes, John Edwin, Department of Trauma and Orthopaedics, Basildon University Hospital, Basildon SS16 5NL, Essex, United Kingdom
Alvin JX Lee, Medical Oncology, UCL Cancer Institute, London WC1E 6BT, United Kingdom
Author contributions: Vusirikala A and Ensor D performed a literature search, created the data collection proformas, collected the data, wrote the manuscript; Asokan AK collected the data, interpreted the data and wrote the results section; Lee AJX performed statistical analysis on the data; Ray R and Tsekes D edited the manuscript; Edwin J designed the study, provided guidance on data collection proformas, edited the manuscript; all authors provided final approval for the paper to be published.
Institutional review board statement: This study was reviewed by the Research and Ethics Committee at the Basildon and Thurrock University Hospitals NHS Foundation Trust who felt this study did not require ethical approval.
Informed consent statement: All subjects involved in the study gave their informed consent verbally.
Conflict-of-interest statement: None of the authors had any conflicts of interest to declare.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at anuhya.vusirikala@nhs.net. Participants consent was not obtained but the presented data are anonymized and risk of identification is low.
STROBE statement: The authors have read the STROBE statement- checklist of items, and the manuscript were prepared and revised according to the STROBE Statement- checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anuhya Vusirikala, MBChB, Surgeon, Department of Trauma and Orthopaedics, Basildon University Hospital, Nethermayne, Basildon SS16 5NL, Essex, United Kingdom. anuhya.vusirikala@nhs.net
Received: October 18, 2020
Peer-review started: October 18, 2020
First decision: November 18, 2020
Revised: December 2, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 18, 2021
Processing time: 82 Days and 2.4 Hours
Research background

The coronavirus disease 2019 (COVID-19) pandemic resulted in seismic changes in healthcare delivery. Due to the high transmission risk of this infection, hospital footfall required to be reduced rapidly. Trauma and Orthopaedic clinics are one of the busiest clinical environments with high volume and rapid turnover of patient attendance. Running these clinics with appropriate social distancing to reduce the spread of infection was deemed challenging. To ensure patients can continue to safely access healthcare, we introduced orthopaedic clinic telephone consultations within our department in a busy district general hospital in England.

Research motivation

Telephone consultations were rapidly implemented within a department with no pre-existing remote consultation model in order to adapt to the COVID-19 pandemic. But in order to ensure patients received high quality care it was vital to obtain patient and clinician satisfaction with this method of remote consultation.

Research objectives

This study aimed to investigate patient and clinician perspective of telephone consultations during the COVID-19 pandemic, and whether this method of remote consultation could be a viable option in the post- pandemic future.

Research methods

This is a single centre, prospective study conducted in a busy National Health Service district general hospital. 100 non- consecutive adult patients were contacted within 48 h of their telephone consultation to complete a patient satisfaction questionnaire which assessed satisfaction with various aspects of the consultation including willingness to continue this method of consultation in the long term. Clinician perspective and satisfaction with conducting these telephone consultations was also sought.

Research results

93% of patients were overall satisfied with telephone consultations and 79% were willing to continue this method of consultation post- pandemic. Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment. 72% of clinicians reported overall satisfaction with this service and 80% agreed that telephone consultations should be used in the future. The majority found it less laborious in time and administration in comparison to face to face consultations. There was no statistically significant difference (P < 0.05) in the level of satisfaction between age groups, gender and diagnosis of upper or lower limb injuries. There was also no statistically significant difference between willingness for telephone consultations during the current pandemic and willingness for telephone consultations in the future.

Research conclusions

This study has proved that telephone consultations are an effective alternative that can be implemented rapidly to provide high quality healthcare during these unprecedented times. This method of consultation has resulted in immense clinician and patient satisfaction. Our findings suggest that this tool has benefits in the post-pandemic healthcare delivery.

Research perspectives

Although the number of patients and clinicians included was relatively small, this study provided a snapshot of patient and clinician satisfaction with the rapid implementation of telephone consultations, achieving the aim of reducing hospital footfall in response to the COVID-19 pandemic. It also highlighted the need to further improve patient experience of remote consultations with the safe and planned introduction of the more complex platform of video consultation services.