No abstract

Published guidelines recommend early transfer of patients with hip fractures to hospital wards and avoidance of unnecessary delays in A&E. We describe a protocol whereby the liaison of an orthopaedic trauma co-ordinator with A&E reduced A&E-to-ward transfer times by 43%. Following introduction of the new protocol, 39% of hip fracture patients were in a ward bed within 3 h of admission to A&E compared to 4% previously. The new protocol also reduces administrative workload for the on-call orthopaedic SHOs.

We examined all minor orthopaedic trauma patients requiring surgical intervention at Manchester Royal Infirmary over a 6-month period to determine whether minor trauma patients meet the day surgery requirements in terms of medical fitness, analgesia requirements and postoperative complications. A total of 83 patients had surgery for minor orthopaedic trauma in the defined period. Of these patients, 79 (95.2%) were medically fit, 45 (70%) were admitted to a hospital ward and 19 (30%) were brought back to day surgery. None of the patients attending day surgery developed postoperative complications or required return to hospital. The majority of patients admitted to a ward required simple or no analgesia pre-(95.5%) and postoperatively (100%), and most were discharged on the same (55.6%) or next (35.6%) day of their operation. We suggest a protocol whereby patients with minor trauma are brought back to day surgery. This could potentially reduce pressures on bed availability.