Social Worker Presence in Outpatient Fracture Clinics: A Batched Stepped-Wedge Cluster Randomized Trial

Status: Recruiting
Location: See all (2) locations...
Intervention Type: Other
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Every year, many Canadians sustain a fracture that requires surgical treatment and results in a long recovery period. During this recovery period, patients may experience new or worsening mental health issues including depression, anxiety, or post-traumatic stress disorder. Additionally, patients may experience new or worsening social and financial problems, such as food and housing insecurity, due to being unable to work or take care of other daily responsibilities. Current care for fracture patients is focused on treating their physical injuries and overlooks these other challenges. To address this gap in care, the investigators propose having a social worker available in the fracture clinic to provide patients with support beyond the care of their physical injury. The investigators propose a trial of 2,000 patients to determine if social worker support improves recovery for patients after a serious fracture by reducing the number of times they return to the emergency room or urgent care centre. This trial will also determine if social work support improves patients' mental health, financial security, ability to work, and level of satisfaction with the care they receive, and whether it reduces the amount of opioid medication they use and number of missed visits during their recovery. Patients will be randomly assigned to receive either support from a social worker or usual care. For patients assigned to receive social worker support, the social worker will assess their individual needs and provide support, information, and referrals to social support services. The social worker will continue to support patients for up to one year after they join the trial. Patients will complete questionnaires at enrollment and at 6 weeks and 3, 6, 9, and 12 months after enrollment. If this trial shows that support from a social worker in the fracture clinic during their recovery period is beneficial to patients who have experienced a serious fracture requiring surgery, it has the potential to change care for patients who experience these potentially life-changing injuries.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Aged 18 or older.

• Has fracture of the appendicular skeleton

• Fracture required surgical management.

• Fracture occurred within the past 12 weeks.

⁃ 3\. Willing to comply with the protocol. 4. Willing to provide informed consent.

Locations
United States
California
Zuckerberg San Francisco General Hospital and Trauma Centre
RECRUITING
San Francisco
Other Locations
Canada
Hamilton Health Sciences - Hamilton General Hospital
NOT_YET_RECRUITING
Hamilton
Contact Information
Primary
Paula McKay, BSc
mckayp@mcmaster.ca
1-289-237-0791
Backup
Natalie Fleming, MSW
flemin3@mcmaster.ca
Time Frame
Start Date: 2025-10-06
Estimated Completion Date: 2028-06
Participants
Target number of participants: 2000
Treatments
No_intervention: Usual Care Arm
Participants enrolled during the usual care phase will receive the current standard treatment for their fracture. The current standard of care post-surgery for fractures, in the fracture clinic, is to provide medical treatment for injuries including casts, monitoring for infection, x-rays, etc. This is provided by surgeons, nurses and technicians. Any psychosocial needs are managed at patient request either by the surgeon or another clinic health care professional (in the case of simple forms) or by a hospital social worker, who usually has a full-time workload outside of the fracture clinic.
Active_comparator: Social Work Intervention Group
Participants enrolled during the treatment phase at their clinic will receive social work support for 6 months from the time of enrollment. They will have an intake appointment with the social worker before or during their initial fracture clinic visit to assess their needs, identify goals that they can address with the support of the social worker, and collaboratively formulate a personalized care plan tailored to their specific circumstances. The social worker will then implement the plan, which may involve educating participants and their support network, coordinating delivery of care and benefits, making referrals to community services, advocating for the participant, and providing emotional support and brief counselling. The social worker will be accessible to participants for 6 months post-enrollment, following up via telephone, telemedicine or in-person to evaluate the effectiveness of the care plan and offer sustained ongoing support.
Related Therapeutic Areas
Sponsors
Leads: Sheila Sprague
Collaborators: Orthopaedic Trauma Association, McMaster Surgical Associates

This content was sourced from clinicaltrials.gov

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