improving patient care
The Ohio State University Wexner Medical Center connects orthopedic patients to the right care at the right time
An orthopedic mobile outreach program at The Ohio State University Wexner Medical Center is improving care delivery for vulnerable patients, reducing the need for hospital admissions and removing barriers to care that were caused by COVID-19.
Ortho CONNECT provides on-site care and consults at skilled nursing facilities and through telehealth.
“This is a team effort,” Carmen Quatman, MD, PhD, orthopedic surgeon, says. “We’re focused on getting the right care to patients, at the right time and place, without interrupting their other health care needs.”
Community-based orthopedic outreach
Quatman, together with physician assistant Caitlin Boulger, PA-C, and orthopedic surgeon Laura Phieffer, MD, sees patients in person and via video and consults along the way with nurses and other nursing facility staff.
Without a service like Ortho CONNECT, patients might spend a full day traveling to and from a follow-up appointment, missing that day’s physical therapy. During the COVID-19 pandemic, patients who leave the nursing facility, regardless of their COVID-19 test results, must also quarantine for 14 days after a visit to their doctor.
Ortho CONNECT provides:
- Direct transfers to the hospital (bypassing the emergency department) when needed
- Follow-up appointments
- Injections for pain management
- On-site consults for new injuries like a fracture
- Physical therapy
- Splint changes
- Wound care
Patients at skilled nursing facilities may be there while they recover from an orthopedic surgery, a heart attack or stroke or other illness.
“Post-op care is critical,” Quatman says. “This way, we can follow patients more closely.”
Launched in 2018, Ortho CONNECT was already approved to be on-site when the COVID-19 pandemic hit. This allowed the team to maintain that access and prevent patients from needing to travel for their regular follow-up care.
When patients do need off-site transport, Ortho CONNECT works with facility staff to ensure that residents get in and out of their transport safely.
Breaking down barriers with telehealth
The pandemic provided a great opportunity to increase and improve telemedicine services. The Ortho CONNECT team and nursing facilities now rely on telemedicine as one more way to break down barriers to care.
Telehealth allows for consultations, physical exams and even X-ray readings. The ability to see the patient helps Quatman decide if she needs to send a team to the facility to provide treatment.
Ortho CONNECT takes services like casting and splinting to the skilled nursing facility so that, if a patient breaks a bone, they can avoid having to visit the emergency department.
Quatman says telehealth also helps improve bone health. If a heart patient’s arthritis makes their physical therapy difficult, the Ortho CONNECT team can offer tips or injections to help. She uses the service to consult with endocrinologists and bone health experts to provide education and treatment for osteoporosis. These remote-care tactics all help give nursing facility patients access to care sooner — before they experience a fracture.
Improving communications, expanding services
The Ortho CONNECT service strengthens the lines of communication between orthopedics and the geriatricians who treat many of the same patients.
“Because we’re present, they bring us onboard a lot earlier,” Quatman says.
Now that more geriatricians and facilities know about Ortho CONNECT, the volume of patients it sees is growing. Individual patients and referring doctors are choosing the Ohio State Wexner Medical Center for care because they know Ortho CONNECT is available, Quatman says.
Ortho CONNECT now works with five skilled nursing facilities around central Ohio, with more expected to join the list of participating facilities.
Ortho CONNECT recently was recertified with premier status by the International Geriatric Fracture Society and is one of just 20 centers in the world certified by the organization. It is a testament to how well Ortho CONNECT cares for some of the sickest patients while at the same time avoiding readmission to the hospital.
“This is an elevation of the fact that we provide safe care for geriatric patients,” Quatman says. “We’re the last stop for many patients. The fact that we’re leading the nation in safe care metrics is exciting for us. We take great pride that we can care for them at such a high level.”