Improvement in hand trauma service at a regional plastics surgery unit in merseyside (BSSH Guidelines)

Published Date: 14th August 2018

Publication Authors: Adjei B, Alfeky H, Bell D, Kelsey C, Nair M

​Aim

The 2007 British Society for Surgery of the Hand (BSSH) guideline contains the timeframe in which all hand trauma needs to be assessed and managed. Whiston Hospital is one of the regional plastic surgery units in the UK. An institutional audit performed in 2015 found the overall compliance with the guideline to be low (73.7%). The Hand trauma service was therefore re-organised. Two successive audits were then performed.

Methods

Hand trauma patients from the Merseyside catchment (North of Wales, Merseyside, Isle of Man) in 1-3 months period were audited in September 2016 and September 2017. The results were compared to the original audit to delineate further improvement.

Results

Time to first review in clinic reduced from 3.07 to 1.86 days (p=0.001) between the first two audits and contined to decrease in the third audit, 1.81. The number of patients listed for surgery increased in the subsequent audits, 75 vs 145 vs 160. The time to surgery increased from 2.4 days to 3.5 days between the first 2 audits. The overall compliance rate with the BSSH guidelines increased 74% vs 84% vs 89%.

Conclusion

The hand trauma service in Merseyside has improved significantly since 2015. There is still scope for further improvement.

 

Adjei, B; Alfeky, H; Nair, M; Kelsey, C; Bell, D. (2018). Improvement in hand trauma service at a regional plastics surgery unit in merseyside (BSSH Guidelines). International Journal of Surgery. 55 (Suppl 1), S97

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