Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.921
Peer-review started: May 8, 2022
First decision: August 4, 2022
Revised: August 17, 2022
Accepted: September 23, 2022
Article in press: September 23, 2022
Published online: October 18, 2022
Processing time: 161 Days and 12.8 Hours
Coronavirus disease 2019 (COVID-19) has necessitated adaptations in local trauma services, with implementation of novel methods of practice, strategic changes, and shifting of resource management. Many of these changes may serve the driver for landmark changes to future healthcare provision. The pandemic environment is full of opportunities to capitalise upon to improve the flexibility of care provision for the benefits of both, patients and providers, with the ultimate aim of creating a long-term self-sustaining care model.
We sought to compare throughput and productivity metrics with preceding years to identify differences in practice that were successful, cost-effective, and sustainable. Should these changes prove successful, they may yield more sustained differences to the way we deliver care in the future.
By evaluating changes to practices implemented due to COVID-19 at our trauma unit, our goal was to evaluate those changes that were successful, cost-effective, easily adapted by clinicians, and deemed sustainable for the future, with a view to sharing our learnings more widely.
We performed a comprehensive retrospective analysis of the objective impact of COVID-19 on our local trauma service provision, by comparing 2020 metrics with the equivalent 12-mo time periods in both 2019 and 2018.
Of 1704 cases were admitted in 2020, 11.9% and 12.4% fewer than 2019 and 2018, respectively. Hip fractures remained the bulk of surgical workload at the height of the pandemic. Mean length of stay was shorter during phase 1 (5.7 d). The time in theatre was longer (144.3 min) as a consequence of COVID-19 related measures that were introduced into theatre practice. Only the most co-morbid patients were admitted into hospital during phase 1, indicated by higher Charlson (0.90) and Elixhauser Comorbidity Indices (1.55).
By evaluating, analysing, and comparing local trauma throughput variation during the pandemic, we developed targeted interventions utilising an ‘elective care model’ for more efficient trauma care.
COVID-19 has resulted in a paradigm shift in how care is accessed and delivered, with many evolving changes and adaptations likely to leave an impression upon healthcare provision in the future.