Exploration of a new rural hospital service model; an Allied Health led Fracture Clinic

Ms Hannah Christensen1, Dr Petrea Cornwell2, Dr Elizabeth  Ward3

1South West Hospital And Health Service, Roma, Australia, 2Allied Health Research Collaborative, The Prince Charles Hospital , Chermside 4032, Australia , 3Centre for Functioning and Health Research, Metro South Hospital and Health Service, Buranda, Australia

Abstract:

Background

This study evaluated the implementation of a model of care in which allied health (AH) staff worked in an advanced scope of practice role to deliver fracture clinic (FC) follow up care in a rural hospital setting. This was provided under the clinical guidance of an external orthopaedic consultant in a rural hospital setting.

Methods

This study was a comparison of outcomes on service efficiencies and staff perceptions of a TRansdisciplinary Allied health delivered Fracture Follow-up Clinic (TRAFFIC) compared with the previous medically-led FC model. Clinical data for the different models was collected for five months and compared. Outcomes included patient and staff perception surveys and functional recovery questionnaires.

Results

Comparison revealed that the implementation of TRAFFIC resulted in a reduction in patients being lost to follow up after leaving ED (72% to 6%) as opposed to the medically-led FC. A reduction in demand for local medical officer involvement in follow up fracture care (100% to 6%), without any loss in fracture healing or functional recovery. Regular involvement of a remote orthopaedic surgeon consultation into TRAFFIC meant fracture diagnoses were revised (n=13) and revision of initial management which could have led to adverse events (no=9). Overall, there was high patient satisfaction with TRAFFIC; 95% of patients seen were satisfied or very satisfied with their review appointments. Staff also provided positive feedback about AH staff delivering the care from consumer and clinicians reported on survey feedback.

Discussion and recommendations

AH were able to safely and efficiently provide an advanced scope service for fracture follow-up in a rural context, allowing medical officers to attend to more acute emergency department presentations.


Biography:

Hannah is a physiotherapist who has worked in various project and leadership roles within Queensland Health across both metropolitan tertiary hospitals and rural settings. She is currently undergoing a expanded scope of practice Child Development Redesign for a rural context and has a passion for adjusting service delivery models to meet the needs of the rural community.