Patient satisfaction in virtual upper-limb orthopaedic clinics: a retrospective review

BMJ Open Qual. 2025 Mar 5;14(1):e002938. doi: 10.1136/bmjoq-2024-002938.

ABSTRACT

BACKGROUND: The COVID-19 pandemic halted elective orthopaedic surgeries, necessitating alternative consultation methods. Virtual consultations emerged as a solution to manage elective waiting lists for conditions such as carpal tunnel syndrome, stenosing tenosynovitis and Dupuytren's contractures. This study aimed to evaluate the effectiveness and patient satisfaction of virtual consultations in an upper-limb orthopaedic clinic.

LOCAL PROBLEM: Elective waiting lists for conditions such as carpal tunnel syndrome, stenosing tenosynovitis and Dupuytren's contractures increased significantly, requiring alternative consultation methods.

METHODS: The Virtual Upper-Limb Clinic was composed of a virtual consultation, which included a focused history and examination. If there is uncertainty of diagnosis or a lack of appropriate examination findings at that time, the patient would then be booked into an in-person clinic for further assessment.If the virtual examination demonstrated marked pathology, surgical treatment would be proposed. Patients accepting surgical management were assessed and diagnosed formally on the day of surgery, followed by another virtual consultation postoperatively. The aim of this study is to demonstrate overall advantages and patient experiences of the virtual clinic. Data were collected in a retrospective manner using an improvised questionnaire based on the Telehealth Satisfaction Scale.

INTERVENTIONS: Patients received focused history and examination assessments via video consultation. Surgical treatment was carried out electively if required, followed by a postoperative virtual review.

RESULTS: Fifty patients were included, predominantly female, with an average age of 57.48 years. Diagnoses included 25 carpal tunnel cases, 15 trigger fingers, two ganglion cysts and eight Dupuytren's contractures. Ninety-six per cent of patients were satisfied with the virtual service, citing reduced travel costs and convenience. However, only 54% preferred virtual consultations preoperatively.

CONCLUSIONS: Virtual upper-limb orthopaedic clinics provide a safe, cost-effective and satisfactory alternative to in-person care. However, preferences varied, underscoring the need for a hybrid model integrating virtual and in-person consultations based on clinical and patient needs.

PMID:40044454 | DOI:10.1136/bmjoq-2024-002938