Trauma Triage Clinics to improve care for fracture patients

Published: 7 October 2015

Torbay and South Devon NHS Foundation Trust is introducing an innovative approach for patients with broken bones which will help reduce the number of hospital appointments they need to attend.

Traditionally, all patients with fractures (breaks) are seen in a fracture clinic within a few days of attending the Emergency Department or Minor Injury Unit (MIU). Some patients will be discharged at this fracture clinic appointment without any change in their treatment. The Trust is aware from feedback received that this can be frustrating for patients who may have arranged transport, child care cover and time off work in order to attend, as well as possibly experiencing a long wait in the clinic.

The new approach means that for several common fractures and predictably stable injuries, patients who have received the appropriate treatment in the Emergency Department or MIU will either be discharged with the appropriate advice at that time, or their notes and x-rays will be reviewed by a Consultant Orthopaedic Surgeon in a new Trauma Triage Clinic.

Rather than having to attend the clinic in person, the patient will then be contacted by telephone at a pre-arranged time by a senior fracture clinic nurse who will relay the consultant’s opinion. At this point, the patient may be discharged with reassurance and advice, or an appropriate fracture clinic appointment arranged if necessary.

Trauma Triage Clinics are an improved version of, and replacement for, the Virtual Fracture Clinics which have been successfully piloted by the Trust over the past two years to manage five common fractures. Trauma Triage Clinics will lead to a reduction in the number of unnecessary appointments for many patients, and will free up additional time for clinicians to spend on patients with more unpredictable and complicated injuries. These changes will create a greatly improved experience for all the Trust’s fracture patients.

Mr Archie Hawken, Consultant Orthopaedic Surgeon said, “Our aim is to provide the best possible care and the best medical outcome for our patients, without unnecessary waits, appointments and transport costs.

“The Trauma Triage Clinics are an expansion of our already popular and successful Virtual Fracture Clinics, which help over 600 patients a year avoid unnecessary appointments, whist still getting the best outcome from their injury. The new process also includes an open door policy, so patients with any concerns can easily obtain further advice and an appointment if required.”

Feedback received from the Virtual Fracture Clinics includes the following comments:

  • “Pleased not to have to come back unnecessarily”
  • “great service”
  • “information given when Fracture Clinic called – very helpful”
  • “excellent, better than wasting people’s time”
  • “really good service”
  • “so good not to have unnecessary appointment when I’m a busy mum”