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Pain and function deteriorate in patients awaiting total joint arthroplasty that has been postponed due to the COVID-19 pandemic

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World Journal of Orthopedics 2021年第3期12卷 152-168页

作者： Jurek Rafal Tomasz Pietrzak Zia Maharaj Magdalena Erasmus Nkhodiseni Sikhauli Josip Nenad Cakic Lipalo Mokete Department of Orthopaedics University of the WitwatersrandJohannesburg 2193GautengSouth Africa Department of Orthopaedic Surgery Charlotte Maxeke Johannesburg Academic HospitalJohannesburg 2193GautengSouth Africa Department of Orthopaedic Surgery Life FourwaysJohannesburg 2193GautengSouth Africa

BACKGROUND Elective total joint arthroplasty(TJA)procedures have been postponed as part of the coronavirus disease 2019(COVID-19)response to avert healthcare system *** hip arthroplasty(THA)and total knee arthroplasty(TKA)procedures comprise the highest volume of elective procedures performed at health care facilities *** To determine the demand for TJA despite the pandemic and the impact of surgery postponement on physical and mental *** We conducted a prospective cross-sectional telephonic interview-based study on patients awaiting THA and TKA at an academic institution in South *** questionnaire consisted of four *** first section recorded baseline demographic data and medical co-morbidities,the length of time spent awaiting TJA,and the patients’desire to undergo elective surgery despite the COVID-19 *** 2 and Section 3 assessed the patients’current physical and mental health,respectively,as a consequence of deferred surgical *** last section established the patients’perception of the healthcare system’s response to the COVID-19 pandemic and necessity to postpone elective *** received counseling and education on the current state of surgery during the COVID-19 pandemic and associated ***,patients were once again asked about their desire to undergo TJA during the COVID-19 *** We included 185 patients(65.95%female;mean age:50.28 years)awaiting TJA for a mean of 26.42±30.1 ***,88.65%of patients wanted TJA despite the COVID-19 *** awaiting TJA for 1-3 years were 3.3-fold more likely to want surgery than those waiting<1 year(P<0.000).Patients with comorbidities were 8.4-fold less likely to want TJA than those with no comorbidities(P=0.013).After receiving education,the patients wanting TJA decreased to 54.05%.Patients who changed their opinion after education had less insight on the increased morbidity(P=0.046)and mortality(P=0.001)asso

关键词： Total hip arthroplasty Total knee arthroplasty Elective surgery COVID-19 waiting lists Primary total joint arthroplasty

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Reducing Paediatric Outpatient Waitlists—A Proposed Allied Health Multidisciplinary Approach

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Open Journal of Preventive Medicine 2021年第2期11卷 63-70页

作者： Hsien-Jin Teoh Millie Darvell Redcliffe Hospital Metro North Hospital and Health Service Queensland Australia Private Practice Queensland Australia

Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children may benefit from allied health input, in addition to being seen by the paediatrician. This paper provides an organisational strategy that involves streamlining Allied Health clinical services in an effort to assist with bringing down a Paediatric Out-patient waitlist. The paper describes principles to guide the formation of a Paediatric Allied Health Multi-Disciplinary team that proposes assessment and brief interventions. The service would focus on supporting the paediatricians through the use of structured procedures, telephone intakes, multidisciplinary triage, shared and standardised assessments, collaborative formulations and reports, brief interventions, clinical-community linkages, and allied health student support. A variety of additional important organisational principles are proposed to facilitate patient flow from the perspective of streamlining administrative processes, having adequate administrative support, shared responsibilities, teamwork, flexibility, carrying out intake assessments, determining which referrals were appropriate for allied health, and working closely with medical staff.

关键词： Paediatric Out-Patient Allied Health Multi-Disciplinary waiting lists

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