The beneficial impact of pre-operative hand therapy appointments for plastic surgery hand trauma patients

Title : The beneficial impact of pre-operative hand therapy appointments for plastic surgery hand trauma patients

Abstract:

Aims: BSSH standards of care in soft tissue hand trauma have a clear 3-5 day target for hand therapy post-operatively. However, due to lack of patient education or mismanaged expectations, this target is frequently breached. Our project aimed to improve outcomes for hand trauma patients within the department. We aimed to evaluate the sustainable value of implementing a pre-operative consultation with the hand therapy team.

Methods: This prospective study identified new patients suffering with soft tissue hand trauma during April 2024, assessing patient outcomes, total number of appointments, including those missed, breach of 3-5 day target and total dressings costs. A modification to the pathway of patients was made, with a view to reduce missed appointments and improve outcomes, enabling patients to be seen by a hand therapist pre-operatively. This intervention was deemed to improve patient education and stress the importance of post-operative rehabilitation. The unit was re-assessed in September 2024.

Results: For all patients there was a statistically significant reduction in complications, number of appointments, number of missed appointments and duration under consultant care. This was forecasted to save our trust £88,000 per year. The reduction in appointments, translated to an added environmental benefit, with an average saving of 171.6kgCO2e per patient. Verbal feedback from patients was positive, with a reduction in stress and anxiety pre-operatively.

Conclusions: This study has demonstrated sustainable value across environmental, social, financial and clinical perspectives. The impact of this small process change, which required minimal disruption to service, had a significantly positive impact on patient experience and outcomes, it created a more efficient use of NHS resources with a more cohesive working between Hand Therapy and Plastic Surgery, whilst also benefiting the environment.

Biography:

Milen Santhosh is a final-year medical student at Plovdiv Medical University, Bulgaria, currently interning at St. George’s Hospital in Plovdiv, set to graduate in 2025. Passionate about medical education, Milen leads weekly teaching sessions with the PeerMed group, helping peers improve their knowledge. Interested in research, Milen joined Dhanuja Senn’s team, finding the project both engaging and valuable. This opportunity has enhanced his understanding of evidence-based medicine and honed critical research skills. Milen aims to contribute to medical advancements and continue supporting and educating fellow students, with a strong commitment to both clinical practice and academia.