THE LIST: TRANSFORMING THE ORTHOPAEDIC TRAUMA MANAGEMENT AND HANDOVER IN A SUSTAINABLE AND COST-NEUTRAL WAY

Abstract

Trauma, across the United Kingdom, is managed using several software, paper based lists on Microsoft Word/Excel or Teams. There is usually poor handover or no handover in a standard format- during the on call, in the trauma meetings or in the wards. The software in the market for trauma management are not cost friendly or adaptable to local demands. The alternatives like Microsoft WORD based lists are fraught with their own problems. We endeavoured to make our trauma management effective.A Quality Improvement Project was done. The goals to achieve at end of a year were:Daily Trauma Handover in standardised format >90%Ward Handover in standardised format >90%Availability of outcomes of patients in clinic >80%Reduction of paper usage >90% at the end of six monthsAvailability of updated “outliers” information >90% at the weekend ward roundDocumentation from the Trauma Meeting > 90%On-Call documentation in standardised format >90%Doctor Satisfaction >75% in terms of: ease of us;, searchability of patient; ward round experience; morning trauma meeting experience; handover experience; inter-specialty communication; reliability; daily time saving; on-call time saving; patient care/safety; overall satisfaction.We used Microsoft Sharepoint List to manage our trauma workload and have named the tool as “The List”. The List has achieved all objectives as above in one year's time, except Outlier information which was at 67% in a recent PDSA (Plan-Do-Study-Act) cycle. The survey showed excellent doctor satisfaction and 90% respondents felt that The List saved an hour or more during the on-call and also during the ward rounds.We conclude that The List is a very powerful tool making trauma meetings efficient and handover effective. It is indigenous, adaptable, safe, sustainable, cost neutral and easy to use.