This was an innovation project supported by the Better Care Victoria Innovation Fund.
The Royal Melbourne Hospital
- Western Health
- North Western Melbourne Primary Health Network
Rising activity at Victorian public hospital emergency departments (EDs) has increased demand on outpatient services, including orthopaedic clinics.
To reduce this demand, The Royal Melbourne Hospital and Western Health implemented a virtual fracture clinic (VFC), an innovative model of care pioneered at the Glasgow Royal Infirmary in the UK.
This model of care involves virtual management of certain acute orthopaedic conditions instead of management through face-to-face clinic consultations. Patients are given standardised advice on how to self-manage their condition, which is reinforced with educational resources and referral to community services such as physiotherapy.
By enabling patients with simple fractures and soft tissue injuries to receive clinical advice over the phone, the two health services aimed to deliver more timely, convenient care.
- Increase the capacity of fracture clinics through virtual management of appropriate acute orthopaedic injuries
- Avoid ED re-presentations of patients managed virtually
- Improve the hospital experience of patients with acute orthopaedic injuries
- Reviewed 1,276 patients across both VFCs, with 290 (23 per cent) directly discharged without a face-to-face clinic appointment
- Fewer than 1 per cent of patients managed virtually re-presented to the ED within 30 days
- Received high satisfaction ratings from patients, with the majority saying they would recommend the service
October 2017 – Both The Royal Melbourne Hospital and Western Health are seeking executive approval to sustain the VFC. The condition-specific management guidelines developed during the project will be shared with general practitioners (GPs). The long-term goal is to provide GPs with direct access to the VFC so that simple orthopaedic conditions can be safely and effectively managed in the community, reducing unnecessary ED presentations.