307 Improved Compliance with Enhanced Recovery Protocol Medications for Elective Joint Replacements Using the E-Lective App

Abstract

Abstract Aim Enhanced recovery pathway(ERP) in elective joint replacements has been shown to reduce length of stay, reduce re-admission rates, and can improve early functional recovery. Local analgesia and VTE prophylaxis protocol in current use has been produced by members of the multidisciplinary team but awareness of it needs to be optimised. Method We performed a retrospective review of discharge summaries and prescriptions from April 1 to April 30, 2021, of all primary joint replacements at Chelsea and Westminster Hospital. These were assessed against the local ERP Protocols for elective arthroplasties. ‘E-Lective App’ - a peer to peer shared mobile application containing an offline repository of existing Enhanced Recovery medication protocols, ward directory and follow-up booking feature was presented to clinical staff at the clinical governance meeting. Prior to these, protocols were only accessed or shared through WhatsApp. Re-assessment was done a three months later for a period of one month’s July 1 to July 31, 2021. Results Prior to launching ‘E-Lective App,’ compliance with the ERP Discharge Medications protocol was 70.1%. At last review in July 2021 this had significantly improved to 96% on average (p<0.05). Readmission rate due to pain and swelling had decreased by 65%. Conclusions This quality improvement project highlights the need to innovate to improve compliance to current standards of prescribing medications as part of the Enhanced Recovery Protocol. ’E-lective app’ is a novel and effective guide on maximising ERP pathway for joint replacements.