Clinical Medicine And Health Research Journal

To Evaluate the Effectiveness of Innovative Care Models in Improving Patient Outcomes and Operational Efficiency in Healthcare

2025-04-30T13:50:15+00:00

Innovative care models have emerged as a critical strategy for addressing the growing complexity and demands of modern healthcare systems. This study evaluates the effectiveness of these models in enhancing patient outcomes and improving operational efficiency across various healthcare settings. Drawing upon a comprehensive review of peer-reviewed literature, case studies, and health system performance data, the analysis focuses on widely adopted models such as Patient-Centered Medical Homes (PCMHs), Telehealth, Accountable Care Organizations (ACOs), and Integrated Care Systems. The findings reveal that innovative care models contribute significantly to improved clinical outcomes, including reduced hospital readmissions, better chronic disease management, and enhanced patient satisfaction. Simultaneously, they promote operational gains such as cost reduction, streamlined workflows, and more effective use of healthcare resources. However, outcomes vary based on implementation strategies, workforce readiness, and technological infrastructure. The study underscores the need for evidence-based implementation, stakeholder collaboration, and ongoing evaluation to sustain long-term impact. This evaluation offers practical insights for healthcare providers, policymakers, and administrators aiming to optimize healthcare delivery through innovation.

Correction of Post-Infective Deformities of The Tibia Using the Ilizarov Circular External Fixation

2025-04-23T05:58:54+00:00

Background: Post-infective tibia deformities present significant challenges to orthopedic surgeons in resource-limited settings across sub-Saharan Africa. These conditions impose substantial economic, functional, and psychosocial burdens on patients and their families. The Ilizarov circular external fixator is recognized as a valuable tool in managing complex post-infective deformities, especially in pediatric patients within resource-limited settings.

Objective: To highlight the effectiveness of the Ilizarov circular external fixator in managing complex post-infective tibial deformities in pediatric patients in a resource-limited setting.

Methods: This case series highlights three pediatric patients with severe post-infective tibial deformities and significant limb length discrepancies, managed with Ilizarov external fixator at University College Hospital, Ibadan, Nigeria. Case 1: A 5-year-old female with 20 cm leg shortening and deformities post-surgery for tibia osteomyelitis at 6 months old. Case 2: A 5-year-old male with 6 cm leg shortening and deformity post-osteomyelitis. Case 3: A 9-year-old male with 16 cm leg shortening and deformity post-infection at 5 months old.

Results: Treatment involved multi-staged surgical procedures using Ilizarov circular external fixation. Procedures included soft tissue release, gradual distraction, deformity correction, fibular centralization, tibio-fibular synostosis, and bone lengthening. All patients achieved substantial correction with residual limb length discrepancies of 2-3 cm and minor deformities planned for future correction.

Conclusion: The Ilizarov circular external fixator proves to be a versatile and effective tool for managing complex post-infective tibial deformities in pediatric patients, even in resource-limited settings. This technique allows for simultaneous correction of multiple deformities and limb lengthening with acceptable functional outcomes.

Audit of Orthopaedic Surgical Management and Theatre Utilization at University College Hospital, Ibadan: A 2-Year Retrospective Review

2025-04-26T23:20:56+00:00

Background: Effective surgical management and optimal theatre utilization are critical aspects of orthopaedic practice in resource-constrained settings. This study aimed to audit the patterns of orthopaedic surgical management and theatre utilization at the University College Hospital, Ibadan, Nigeria.

Methods: A retrospective review of all orthopaedic surgeries performed over a two-year period was conducted. Data on patient demographics, diagnoses, surgical procedures, duration of surgery, and ASA classification were collected and analyzed.

Results: A total of 301 orthopaedic surgeries were performed during the study period. The mean age of patients was 44.3 years (range: 2-94 years), with a nearly equal gender distribution (49.8% female, 50.2% male). Emergency procedures constituted 60.5% of all surgeries, while elective procedures accounted for 39.5%. The most common diagnoses were diabetic foot (7.6%), infected implants (2.7%), and open fractures (4.0%). The most frequently performed procedures were open reduction and internal fixation with plate and screw (10.6%), Ilizarov procedures (4.0%), and implant removals (4.0%). The mean duration of surgery was 2.6 hours. Spinal anesthesia was the most common anesthetic technique (50.8%), followed by combined spinal-epidural (28.9%).

Conclusion: This audit revealed a high proportion of emergency surgeries, reflecting the significant burden of trauma in the region. Diabetic foot complications emerged as a leading cause of orthopaedic surgical intervention, highlighting the need for improved diabetic foot care services. The findings provide valuable insights for optimizing theatre utilization and improving orthopaedic surgical care at the institution.