692 Standardised Management of Hallux Fractures Within Virtual Fracture Clinic: A Quality Improvement Project

Abstract

Abstract Aim Hallux fractures are a common referral to Virtual Fracture Clinic (VFC), comprising 6% of all referrals made within our Major Trauma Centre (MTC). The cumulative time taken to process these cases equates to 3.75 hours per month. This commitment of time and resources endeavoured us to evaluate these hallux fracture referrals with the aim to develop a clear treatment pathway to improve the efficiency of VFC whilst safeguarding patient safety. Method A database was created containing all patients seen in VFC between 01/01/2022 and 31/01/2022 (n = 279). From this database 15 hallux fracture cases were identified. Using this data, a treatment pathway was created that stratified hallux fractures into high, moderate and low risk groups. This pathway was then implemented within our local A&E department and surrounding minor injury units to allow clinicians to safely discharge uncomplicated hallux fractures back into the community with appropriate safety netting literature. A 2nd cycle was carried out to evaluate the effectiveness of the treatment pathway by reviewing the number of hallux fracture cases referred to VFC between 17/10/2022 and 14/11/2022. Results After implementing our treatment pathway, we saw a 62% reduction in the number of inappropriate referrals made to VFC. Furthermore, we saw a 100% increase in the number of appropriate complex fractures that were brought back to fracture clinic for formal review. Conclusions Our treatment pathway has demonstrated a significant difference in how hallux fractures are managed within our MTC in a manner that improves efficiency without compromising patient safety.