Trauma assessment clinic: Virtually a safe and smarter way of managing trauma care in Ireland. Issue 4 (April 2019) - O' Reilly, M.
Highlights: The introduction of the TAC at our institution is both safe and cost effective. Of the patients surveyed 97% either agreed or strongly agreed that they had a satisfactory recovery. Each TAC consultation saves approximately €100 versus the traditional "face to face" fracture clinic. Over the period from which it was commenced 2704 patients were referred to the TAC revealing a cost saving of over quarter of a million euro. In terms of patient pathway since the addition of the ESP to the TAC MDT over a third of patients are being followed-up in an ESP led clinic, another third discharged directly and the remainder being followed-up in other review clinics. Abstract: Introduction: 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. Methods and Patients: 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. Results: 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. Conclusion: 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.