Mardinger Cynthia, Steve Anna K, Yeung Justin K
University of Calgary, Cumming School of Medicine, Health Sciences Centre, Calgary, Alberta, Canada.
Division of Plastic Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada.
Plast Surg (Oakv). 2021 May;29(2):128-131. doi: 10.1177/2292550320967399. Epub 2020 Oct 28.
The purpose of this study was to describe the impact of using a multidisciplinary hand clinic on (1) hand clinic waitlists for urgent operative pathologies and (2) the volume of urgent operative referrals seen by plastic surgery.
A retrospective data analysis of all new referrals to the Peter Lougheed Centre hand clinic in Calgary, Alberta, was performed. Data were collected from 6 months before and after the introduction of the multidisciplinary model (ie, between January 2017 and January 2018). Demographics for all new referrals were collected from the clinic database, including wait times, triage type, and volume of referrals triaged to each discipline.
Prior to using a multidisciplinary model, 81% (n = 591) of new patient referrals were triaged directly to plastic surgery, 4% (n = 28) to physiotherapy, and 6% (n = 43) to minor surgery (N = 728). However, following the addition of physiatry to the clinic, 62% (n = 451) of new patient referrals were triaged directly to plastic surgery, 24% (n = 173) to physiatry, 2% (n = 17) to physiotherapy, and 4% (n = 31) to minor surgery (N = 730). Overall, the number of urgent operative referrals triaged to plastic surgery proportionally increased by 7%, from 67% to 74%. Mean wait times for urgent referrals to plastic surgery decreased by 1.7 ± 1.0 months ( = .09).
Applying a multidisciplinary model to a hand clinic can allow non-operative cases to be triaged directly to physiotherapy and physiatry, allowing plastic surgeons to manage a higher volume of urgent and operative referrals. Implementing a multidisciplinary hand clinic can, therefore, decrease waitlist volumes and shorten the time to assessment by a plastic surgeon.
Level II Prognostic Study.
本研究旨在描述采用多学科手部诊所对以下两方面的影响：（1）手部诊所紧急手术病理的等候名单；（2）整形外科所见紧急手术转诊的数量。
对艾伯塔省卡尔加里市彼得·洛希德中心手部诊所所有新转诊病例进行回顾性数据分析。数据收集时间为多学科模式引入前后各6个月（即2017年1月至2018年1月）。从诊所数据库收集所有新转诊病例的人口统计学数据，包括等候时间、分诊类型以及分诊到各学科的转诊数量。
在采用多学科模式之前，81%（n = 591）的新患者转诊直接分诊到整形外科，4%（n = 28）到物理治疗科，6%（n = 43）到小型外科（N = 728）。然而，在诊所增加物理医学与康复科之后，62%（n = 451）的新患者转诊直接分诊到整形外科，24%（n = 173）到物理医学与康复科，2%（n = 17）到物理治疗科，4%（n = 31）到小型外科（N = 730）。总体而言，分诊到整形外科的紧急手术转诊数量按比例增加了7%，从67%增至74%。紧急转诊到整形外科的平均等候时间减少了1.7±1.0个月（P = 0.09）。
将多学科模式应用于手部诊所可使非手术病例直接分诊到物理治疗科和物理医学与康复科，从而使整形外科医生能够处理更多紧急和手术转诊病例。因此，实施多学科手部诊所可减少等候名单数量，并缩短整形外科医生的评估时间。
二级预后研究。
