Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Tullamore, Co. Offaly, R35 NY51, Ireland; Graduate Entry Medical School, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.
Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Tullamore, Co. Offaly, R35 NY51, Ireland.
Injury. 2019 Apr;50(4):898-902. doi: 10.1016/j.injury.2019.03.046. Epub 2019 Mar 30.
The Trauma Assessment Clinic [TAC], also referred to as Virtual Fracture Clinic, offers a novel care pathway for patients and is being increasingly utilised across the Irish and UK health care systems. The provision of safe, patient centred, efficient and cost-effective treatment via a multidisciplinary team [MDT] approach is the primary focus of TAC. The Trauma and Orthopaedic unit at Tullamore Hospital was the first centre to introduce a TAC in Ireland and this overview outlines the experiences of this pilot.
Patients arriving to the Emergency Department with injuries that were TAC appropriate were treated as per a recognised protocol. They were given information regarding their injury and a removable splint or cast and told to expect a follow up phone call from the orthopaedic team. Within 24 h the patient's clinical notes and x-rays were assessed by the TAC MDT and patients were called immediately to be advised as to their planned treatment.
To date the TAC pilot in Tullamore Hospital has reviewed 2704 patients. 35% of patients were discharged at the TAC review stage, 27% were referred to an appropriate clinic (e.g. Shoulder injuries referred to an upper limb specialist) or a general trauma follow-up clinic, and 38% were referred onto physiotherapy services local and community based for follow-up. A survey of patients reviewed in the TAC revealed that 97% of respondents agreed or strongly agreed that they were satisfied with their recovery. The cost of each TAC consultation was €28 versus €129 for a traditional fracture clinic appointment.
Our experience of the TAC is that it provides a very safe, patient focused and cost-effective means of delivering trauma care. It provides a more streamlined and improved patient journey in select patients with certain fracture patterns, allowing for patient empowerment without compromising clinical care and marries current available technology with up to date best clinical practice.
创伤评估诊所（TAC），也称为虚拟骨折诊所，为患者提供了一种新颖的护理途径，并且在爱尔兰和英国的医疗保健系统中得到了越来越多的应用。通过多学科团队（MDT）方法提供安全、以患者为中心、高效和具有成本效益的治疗是 TAC 的主要重点。图拉莫尔医院的创伤和矫形外科是爱尔兰第一个引入 TAC 的中心，该概述概述了该试点的经验。
到达急诊科的 TAC 适合的损伤患者按照既定协议进行治疗。他们获得了有关其损伤的信息以及可移动夹板或石膏，并被告知将收到骨科团队的随访电话。在 24 小时内，TAC MDT 评估了患者的临床记录和 X 光片，患者立即接到电话告知他们计划的治疗方案。
迄今为止，图拉莫尔医院的 TAC 试点已审查了 2704 名患者。35%的患者在 TAC 审查阶段出院，27%的患者被转介到适当的诊所（例如肩部损伤转介到上肢专家）或一般创伤随访诊所，38%的患者转介到当地和社区的物理治疗服务进行随访。对 TAC 审查的患者进行的调查显示，97%的受访者表示同意或强烈同意他们对自己的康复感到满意。每次 TAC 咨询的费用为 28 欧元，而传统骨折诊所预约的费用为 129 欧元。
我们对 TAC 的经验表明，它提供了一种非常安全、以患者为中心且具有成本效益的创伤护理方法。它为某些骨折模式的特定患者提供了更精简和改善的患者就诊流程，使患者能够在不影响临床护理的情况下获得自主权，并将当前可用技术与最新最佳临床实践相结合。
