Escape a fracture nightmare, to a virtual dream! Virtual Fracture Clinic (VFC), from dream to reality.

Jenny Wheeler

Dubbo Hospital, Myall St, Dubbo, NSW, 2830, jenny.wheeler@health.nsw.gov.au

Patients living outside Dubbo, WNSWLHD, were travelling hundreds of kilometres for simple fracture management. Patients, family and friends incurred costs from time off work, school, travel, food, accommodation and discomfit, often for a ten minute service. Historically half of Dubbo’s 110+ fracture clinic patients weren’t Dubbo residents, clinics regularly ran late resulting in staff overtime, with many patients’ travelling after dark.

VFC’s multidisciplinary approach allows retention of specialist orthopaedic review, however patients receive local fracture management. Referrals include peripheral ED’s, GP’s, or an initial treatment at Dubbo fracture clinic with local follow up. VFC patient x-rays, now taken locally, are viewed electronically by the orthopaedic registrar in Dubbo. Management plans are sent to local clinicians where casting/removal is provided by a local physiotherapist or nurse.

Casting occurs primarily in 14 sites, not all employing a physiotherapist, servicing patients from over 30 towns.

Additionally, Dubbo resident’s not requiring x-ray or orthopaedic review now have cast removal in the physiotherapy department, not fracture clinic.

In 20 months-

  1. Fracture clinics in Dubbo decreased by 16%
  • VFC provided 900 OOS
  • Fracture clinic finishes on time
  • Clinic physiotherapists decreased from 3 to 2
  • Peripheral x-rays increased by 338%
  • VFC patients saved 300,000 km travel (8 trips around the world!)
  • Patients saved $198,000 car costs
  • Patients retained $206,100 wages
  • Patient saved on average $449 per visit (not including food and accommodation)

Survey results show patient and staff satisfaction as very high, while maintaining a high quality service.