Kulkarni K, Shah R, Mangwani J, Ullah A, Gabbar O, James E, Dias J. Utilising the impact of COVID-19 on trauma throughput to adapt elective care models for more efficient trauma care. World J Orthop 2022; 13(10): 921-931 [PMID: 36312523 DOI: 10.5312/wjo.v13.i10.921]
Corresponding Author of This Article
Kunal Kulkarni, BMBCh, MA (Oxon), MSc, FRCS (Tr&Orth), European Board of Hand Surgery Diploma, Consultant Trauma & Orthopaedic Surgeon, Department of Trauma & Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, United Kingdom. kunalkulkarni@doctors.org.uk
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Oct 18, 2022; 13(10): 921-931 Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.921
Utilising the impact of COVID-19 on trauma throughput to adapt elective care models for more efficient trauma care
Kunal Kulkarni, Rohi Shah, Jitendra Mangwani, Aamer Ullah, Omar Gabbar, Elaine James, Joseph Dias
Kunal Kulkarni, Rohi Shah, Jitendra Mangwani, Aamer Ullah, Omar Gabbar, Elaine James, Joseph Dias, Department of Trauma & Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, United Kingdom
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting, critical revision, editing and approval of the final manuscript.
Institutional review board statement: This study was formally registered and approved by our Clinical Audit and Quality Improvement Team.
Informed consent statement: No individual patient consent was required as this study utilised unidentifable and anonymised grouped datasets.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kunal Kulkarni, BMBCh, MA (Oxon), MSc, FRCS (Tr&Orth), European Board of Hand Surgery Diploma, Consultant Trauma & Orthopaedic Surgeon, Department of Trauma & Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, United Kingdom. kunalkulkarni@doctors.org.uk
Received: May 8, 2022 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
Core Tip
Core Tip: Based on our findings, we have made several recommendations that we will adopt locally going forward. We encourage other teams facing similar challenges to consider these factors to improve the care of trauma patients: (1) Dynamic elective approaches to care can reduce length of stay (LOS): The ‘elective mindset’ of the elective hospital nursing/physical therapy/occupational therapy teams yielded more expeditious post-operative rehabilitation our trauma patients, ensuring faster optimisation of a more co-morbid cohort of patients and reduced LOS; (2) Sustain the rising trend in safe non-operative management to reduce inpatient workload: This was a trend particularly observed in hand and wrist/foot and ankle trauma where the care pathways were altered in the face of rising coronavirus disease 2019 cases; and (3) Maintaining rapid re-education of skills: By rapidly adopting locally-relevant versions of national guidance and developing standardised algorithms and training pathways.
