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Copy of Copy of 2013 Hand Trauma Audit
Transcript of Copy of Copy of 2013 Hand Trauma Audit
Dr Samantha Conlin
Dr Peter Hutchison
Miss P. Rust
Authors: Dr Ruth Lawless, Dr Nick Spath and Miss P Rust
In light of the BSSH 2007 report to assess hand surgery provision at SJH
Quantify patient load
Identify procedures/adequacy of training
Calculate daycase provision
Authors: Dr Tom Carter,
Miss P Rust
Assessed effect of:
3x week hand trauma lists
DOSA semi-elective booking diary
Hand trauma proforma
190 patients over 8 weeks
23/week (from 11/week)
?improved data collection
32% managed through DOSA unit.
46% managed as day case procedures (inpatients + DOSA) from 22%.
Authors: Dr Harry Sargeant and Miss P Rust
-to assess effect of c-arm and additional Friday hand list
Friday hand trauma list stopped
FY1 discharge form stopped
New consultant specialist hand surgeon (3 in total).
82 patients over 7 weeks
22% of patients were managed as a day case procedures.
Standard set - 95%!
169 patients over 8 weeks
32% DOSA (from 32%)
44% managed as daycase (from 46%)
25% entered in booking diary
50% of the Friday slots were used.
299 procedures in 255 patients over 12 weeks
188 hand trauma (15/wk)
33% (hand, from 32%)
25% (all trauma)
46% (hand, from 44%)
40% (all trauma)
Prospective study over 12 weeks: 31st Dec 2012 to 26th Mar 2013
Comprised all plastics trauma including hand and wrist injuries.
Information obtained using: CEPOD preop list and theatre book; online DOSA booking diary; IDLs and ward admission book.
1. Assess effect of previous cycles on day case hand trauma procedures (inpatient + DOSA)
2. Recommendations to reduce inpatient stay/increase use of DOSA for all plastics trauma patients
Continued improvement from previous daycase patients (44%) to 60-85% (BSSH 2007/previous cycles)
Improvement in data collection.
Recommendation for circulation of plastics shared drive to all FY1s/SHOs.
New C-arm purchased.
Trial of additional Friday hand trauma list.
BSSH 2007 report: Hand Surgery in the UK
Hand surgery as discrete specialty
Increase day case provision
Dedicated lists and equipment to maximise turnover
Operation start time
NCEPOD data operation start time 2003
2012 Deprivation score
Source of referral
Inpatient pre-op nights
Total inpatient stay
Are hand lists truly dedicated esp Mon/Tue?
Appropriate move from out of hours work
Fewer inpatient preop days
Time to look at post op?
DOSA use not improving
No record of patients not operated upon.
Unreliable records of cases performed in the treatment room on W18.
Protected hand trauma list: Should it be Mon/Thur/Fri?
Induction to C-arm booking
More use of regional anaesthesia
Access to Orsis for future
DOSA booking diary
Is there a role for a hand unit coordinator to increase DOSA use? (BSSH 2007)
and 3 dedicated hand trauma theatre lists per week (1/2 day)
3 previous cycles > three/week hand lists, online booking diary, c-arm and additional hand consultant.
Inpatient post-op nights