Abstract
Purpose: This study aims to investigate the benefits of Point of Care (POC) ultrasound and Scheduled Ultrasound Clinics using a Proof of Concept approach in the orthopaedic triage setting.Materials and Methods: The trial ran for a six week period sourcing all patients referred to the orthopaedic triage service. The trial collected three measurable outcomes i.e. two Patient Reported Outcome Measures: MSK-HQ and The Care Measure, and a Proof of Concept clinician survey via Survey Monkey. These were completed by the clinicians and patient cohort during the scheduled clinic and POC clinical contact.Results: A total of 135 patients received a diagnostic ultrasound scan over the six week trial period. 34 patients received a diagnostic ultrasound scan from the Extended Scope Practitioner (ESP) Physiotherapist in a Scheduled Care setting. 101 patients received a diagnostic ultrasound scan from the ESP Podiatrist in orthopaedic triage over the six week period (74 in Scheduled care clinics and 27 at Point of Care). The outcome measure suggest that patients recieved a rapid diagnosis (n.135), implementation of appropriate treatment pathway (86.36%), a positive impact on Referral to Treatment (88.55%), appropriate implementation of conservative treatment (91.11%) and had excellent co-production during the trial with an 88% average CARE Measure Score. The MSK-HQ results suggested a wide variety of muscuoskeletal conditions were asseessed during the trial with a mean MSK-HQ score of 27.6 with a Standard Deviation of 12.Conclusion: Results from clinician sourced Survey Monkey data, The CARE Measure and MSK HQ suggest that POC ultrasound and Scheduled care clinics offer a positive benefit for the patient’s care pathway, are beneficial clinically and suggest adequate demand for the service.
Highlights
Diagnostic ultrasound has been thought of as a rapid, accurate, repeatable, non-expensive, noninvasive and without the risk of radiation [1]
Results from clinician sourced Survey Monkey data, The CARE Measure and MSK HQ suggest that Point of Care (POC) ultrasound and Scheduled care clinics offer a positive benefit for the patient’s care pathway, are beneficial clinically and suggest adequate demand for the service
A total of 135 patients recieved a diagnostic ultrasound scan over the six week period. 83.36% of scans resulted in a change of patient pathway, suggesting the diagnostic ultrasound scan identified an appropriate pathway for the patient
Summary
Diagnostic ultrasound has been thought of as a rapid, accurate, repeatable, non-expensive, noninvasive and without the risk of radiation [1]. It has been used to focus clinical questions, improve differential diagnosis and direct patients to the most suitable treatment [2]. There is a need to define the benefits of appropriate use and, limit any unnecessary imaging and its consequences [3]. It is becoming accepted practice for ultrasound diagnostics to expand beyond the borders of Radiology departments due to the evolving nature of clinical practice and the requirement of prudent healthcare principles [4,5]. Assessment supported by appropriate imaging can often be utilised to ensure the implementation of the right pathway for patients at the earliest opportunity
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