Abstract
Aim
To see if minor upper limb surgery procedures like CTR, Trigger release, Joint injections are safe for a remote telephonic review by specialist nurse. This arrangement was to help maintain our current agreed departmental New to Follow up ratio of 1:1.56 and also to improve access to specialist clinics.
Methods
This was a prospective study. Patients undergoing minor procedures were informed about the remote follow up arrangements when placed on waiting list and on the day of surgery. Patients were assured access to clinic up to 3 months after procedure. A specialist nurse undertook a telephone consultation at 2 and 6 weeks using a proforma provided by the Consultant.
Results
From Dec 2012 to June 2014, we have undertaken a total of 155 minor procedures in 134 patients. We were unable to contact 15 (11%) patients for remote review. Twelve of 39 (30%) in injection subgroup requested repeat injections, they were added to the waiting list saving OPD visit 3(8%) based on response to treatment. In Procedure subgroup 20 needed review of which 15 were reassured and discharged. Only 5 needed further investigations and follow ups.
Twenty-three (15%) out of 155 procedures needed review in clinic. We used available resources prudently avoiding follow up without clinical benefit for 85% of our patients. Five adverse reactions were reported but none of them had complications related to procedure nor did we receive any complaints.
Conclusion
Based on our pilot study “Remote Review” of patients is safe in carefully selected procedures. This innovative arrangement helped us improve the specialist access for more new patients without compromising the patient safety.
