Herding orthopaedic surgeons to create fracture packs
Transforming the communication of evidence for better health
In the run-up to Evidence Live 2016, the organisers asked health science students, junior doctors, and early career researchers to write about projects or innovative ideas that they have been part of and that deal with some of the conference’s main themes (see the box at the end of this article). This article features one of the five winners who gain a free place to attend the conference in Oxford between 22 and 24 June 2016.
Samantha Gallivan, specialist trainee year 8, trauma and orthopaedics, Kingston Hospital, Surrey
In a busy morning our fracture clinic provides orthopaedic care for up to 40 to 50 patients. During these appointments, decisions regarding non-operative or surgical management are made. This is a tough skill for junior doctors to learn because of the speed at which these decisions are made by senior surgeons.
This presents a challenge for everyone: how can we disseminate the best evidence to help manage referrals to the fracture clinic, boost training, and support shared informed decision making between our team and our patients?
Enter the Kingston Hospital Fracture Pack, which is an online guide to the emergency management of 12 common orthopaedic injuries. It contains hyperlinks to the most up to date meta-analyses and systematic reviews, alongside the expert opinion of the hospital’s orthopaedic consultants. The clinical summaries are written using accessible language and linked to open access resources to encourage patients to use them as well. For emergency department doctors, the pack helps with initial management and highlights some of the current controversies and new evidence around orthopaedic care. The pack is updated every 12 weeks by the registrars for each subspecialty and any additions to the pack are presented at our regular governance meetings before they are added.
The most revealing insight gained from this process was bringing senior orthopaedic surgeons together to see how they justify their clinical decisions to one another and how this compares with the evidence.
Evidence Live 2016 conference themes
- Improving the quality of research evidence
- Disentangling the problems of too much and too little medicine
- Transforming the communication of evidence for better health
- Training the next generation of leaders in applied evidence
- Translating evidence into better quality health services