Evaluating the Utility of Using Text Messages to Communicate With Patients During the COVID-19 Pandemic.

INTRODUCTION: We evaluated the use of text messages to communicate information to patients whose surgeries were postponed because of the COVID-19 restriction on elective surgeries. Our hypothesis was that text messaging would be an effective way to convey updates. METHODS: In this observational study, 295 patients received text messaging alerts. Eligibility included patients who had their surgery postponed and had a cell phone that received text messages. Engagement rates were determined using embedded smart links. Patient survey responses were collected. RESULTS: A total of 3,032 texts were delivered. Engagement rates averaged 90%. Survey responses (n = 111) demonstrated that 98.2% of patients liked the text messages and 95.5% said that they felt more connected to their care team; 91.9% of patients agreed that the text updates helped them avoid calling the office. Patients with higher pain levels reported more frustration with their surgery delay (5.3 versus 2.8 on 1 to 10 scale, P value < 0.01). More frustrated patients wished they received more text messages (24.4% versus 4.6%, P value = 0.04) and found the content less helpful (8.2 versus 9.2 on 1 to 10 scale, P value = 0.01). CONCLUSION: Text messaging updates are an efficient way to communicate with patients during the COVID-19 pandemic.

The Emergence of Collaboration in the Education of Fellows and Residents during COVID-19.

BACKGROUND: COVID-19 has created a void in surgical education. Given social distancing and postponed surgeries, unique educational opportunities have arisen. Attendings from 10 adult reconstruction fellowships led a multi-institution web-based weekly collaborative, the Arthroplasty Consortium (AC), developed to educate trainees through complex arthroplasty case-based discussions. METHODS: We performed an anonymous survey of AC participants and American Association of Hip and Knee Surgeons (AAHKS) adult reconstruction fellows. Participants were polled with regards to educational tools used before and after COVID-19 and their value. Specifically, participation in the AC, AAHKS FOCAL (Fellows Orthopedic Continued AAHKS Learning) lectures, institutional lectures, industry lectures, textbooks, online videos, journal articles, and webinars was assessed. RESULTS: Fifty-seven participants responded with 49 (86%) at the fellow level. There was an increase in the use of web-based learning, including the AC (Not applicable pre, 61% post), AAHKS FOCAL lectures (Not applicable pre, 82% post), industry lectures (53% pre, 86% post), and AAHKS/AAOS webinars (35% pre, 56% post). Usage declined with institutional lectures (89% pre, 80% post), textbooks (68% pre, 49% post), and journal articles (97% pre, 90% post), with minimal change in the use of online surgical videos (84% pre, 82% post). The majority of fellows not involved in the AC would like to see the addition of a multi-institutional case conference added to fellowship education. Of AC participants, the 2 most valuable educational tools were the AC and FOCAL lectures. CONCLUSION: Trainee education has changed post-COVID-19 with a greater focus on web-based learning. Multi-institutional collaborative lectures and case-based discussions have significant perceived value among trainees and should be considered important educational tools post-COVID 19.

The Past, Present, and Future of Orthopedic Education: Lessons Learned From the COVID-19 Pandemic.

The COVID-19 global pandemic has upended nearly every medical discipline, dramatically impacted patient care and has had far-reaching effects on surgeon education. In many areas of the country, elective orthopedic surgery has completely stopped to ensure that resources are available for the critically ill and to minimize the spread of disease. COVID-19 is forcing many around the world to re-evaluate existing processes and organizations and adapt to carry out business, of which medicine and education are not immune. Most national and international orthopedic conferences, training programs, and workshops have been postponed or canceled, and we are now critically evaluating the delivery of education to our colleagues as well as residents and fellows. This article describes the evolution of orthopedic education and significant paradigm shifts necessary to continue to teach ourselves and the future leaders of our noble profession.

The Rapid Response to the COVID-19 Pandemic by the Arthroplasty Divisions at Two Academic Referral Centers.

The COVID-19 pandemic has created widespread changes across all of health care. As a result, the impacts on the delivery of orthopedic services have been challenged. To ensure and provide adequate health care resources in terms of hospital capacity and personnel and personal protective equipment, service lines such as adult reconstruction and lower limb arthroplasty have stopped or substantially limited elective surgeries and have been forced to re-engineer care processes for a high volume of patients. Herein, we summarize the similar approaches by two arthroplasty divisions in high-volume academic referral centers in (1) the cessation of elective surgeries, (2) workforce restructuring, (3) phased delivery of outpatient and inpatient care, and (4) educational restructuring.