Title : Senior clinician post-operative reviews following elective total hip and knee replacements - A quality improvement project
Abstract:
Total hip and total knee replacements comprise the majority of elective orthopaedic procedures performed. Guidelines in the United Kingdom recommend that all patients should be reviewed by a consultant at least once every 24 hours. Following the death of an inpatient, a series of quality improvement projects were conducted to investigate adherence to these guidelines in patients undergoing elective hip or knee arthroplasty.
Methods: Patients undergoing elective hip or knee arthroplasty were included in this audit. Our initial audit demonstrated a significant number of patients who were not reviewed by a senior clinician within 48 hours following their operation. The data was presented locally in order to educate staff and develop strategies on how to ensure safe and effective patient care.
Results: A significant improvement was demonstrated, with the percentage of patients reviewed by a senior clinician within 48 hours after their operation rising from 41% to 56%. In addition, our data showed that more patients were being reviewed on day 1 post-operation. Interestingly, patients who were reviewed by a senior clinician within the first 48 hours post-operation had a shorter length of stay in hospital on average than those who were not.
Conclusion: We have demonstrated the importance of post-operative review by senior clinicians in patients undergoing elective procedures, as well as the challenges of implementing 100% adherence. It is vital to carry out such data analysis in order to improve patient safety and to improve our outcomes.
