Adherence of Burn Outpatient Clinic Referrals to ABA Criteria in a Tertiary Center: Creating Unnecessary Referrals?
J Burn Care Res
; 42(6): 1275-1279, 2021 11 24.
Article
in English
| MEDLINE | ID: covidwho-1276189
ABSTRACT
Initial assessment and triage of burns are guided by the American Burn Association criteria for referral to a burn center. These criteria are sensitive but not specific and can potentially lead to over-triage and "unnecessary" clinic visits. We are a Level 1 trauma center with burn subspecialty care, and due to the COVID-19 pandemic, referrals to our multidisciplinary outpatient burn clinic required triaging for virtual care appointments. In order to improve the triage process, we retrospectively reviewed our outpatient burn clinic referrals over a 2-year period, 2018 to 2019, for adherence to American Burn Association criteria. We collected data pertaining to patient and burn characteristics, as well as treatment outcome, to characterize referrals not requiring an in-person appointment. Of the 244 patients referred, 73% met the referral criteria, with 45% of these patients being healed at the first visit and 14.6% requiring surgical management. Mean time from injury to first visit was 9.7 days (mode 6), and the average number of visits was 2. Overall, mean burn size was 2%, with the majority of injuries being partial thickness (71%), located in the hand or extremity (77%). There was a fairly equal distribution of contact (36%), flame (21%), and scald (26%) burns. This study highlights the nonspecific nature of the American Burn Association referral criteria. We found that pediatric and hand burns in particular were over-triaged and lead to "unnecessary" appointments. This information is useful to help adjust referral criteria and to guide triaging of appointments with the evolution of telehealth and virtual care.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Referral and Consultation
/
Burns
/
Triage
/
Continuity of Patient Care
Type of study:
Observational study
/
Prognostic study
Limits:
Adult
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
J Burn Care Res
Journal subject:
Traumatology
Year:
2021
Document Type:
Article
Affiliation country:
Jbcr
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