Improving the weekend spinal ward round at a major trauma centre.

Background/aims: Documentation is key for communicating between members of the multidisciplinary team, allowing for better care, but documentation for spinal patients in the authors' centre was poor.

Methods: Every ward round encounter was analysed for six weekends. Data were analysed and presented to the department.

Dual Surgeon Operating in Reverse Geometry Total Shoulder Replacement: The Learning Curve and Its Effects on Complication Rates.

Aims We analyse the impact of implementing dual surgeon operating for reverse geometry total shoulder replacement (RGTSR) as part of the "Getting It Right First Time" (GIRFT) recommendations in our shoulder and elbow unit, and the learning curve associated with it. Methods We performed a retrospective cohort study comparing operative time and complication rates in patients who underwent RGTSR performed by a single consultant surgeon versus two consultant surgeons over a six-year period in a single centre, in addition to an analysing the learning curve over the same period. Results A total of 74 RGTSRs were performed over a six-year period: 35 patients had a single surgeon perform their procedure and 39 had dual surgeon operating.

Implementing the "Getting It Right First Time" (GIRFT) Report Recommendations: The Results of Introducing a Shoulder and Elbow Multidisciplinary Team.

Objective In this study, we aimed to analyse the impact of implementing the "Getting It Right First Time" (GIRFT) recommendations in our shoulder and elbow unit, which included the introduction of a shoulder and elbow multidisciplinary team (MDT) meeting for all patients being considered for surgery. Methods A retrospective patient case-note review was undertaken to assess the impact of replacing the pre-admission clinic with an MDT meeting. We analysed how many of the proposed management plans were changed as a result of this new MDT, as well as the associated cost savings.

Patient Satisfaction with Face-to-Face Follow-Up versus Telephone Follow-Up after Elective Day Case Hand Surgery.

There has been increasing amounts of work on the use of telephone follow-up (TFU) in trauma and orthopaedics, but little direct work on its use in the follow-up of elective day case hand surgery. The aim of this study is to compare patient satisfaction with face-to-face follow-up (FFU) and TFU after elective day case hand surgery. Sixty-four patients from an FFU and 61 patients from a TFU cohort were contacted by telephone at least 6 months after their last follow-up.

Remote Clinics During Coronavirus Disease 2019: Lessons for a Sustainable Future.

Background The coronavirus disease 2019 (COVID-19) pandemic has led to a focus on non-face-to-face (NF2F) orthopedic clinics. In this study, our aim was to establish whether NF2F clinics are sustainable according to the "triple bottom line" framework by taking into account the impact on patients, the planet, and the financial cost. Methodology This retrospective cohort study was carried out at a large district general hospital with 261 patients identified as having undergone face-to-face (F2F) or NF2F orthopedic consultations (April 2020).

Improving the accuracy of digital templating: achieving success through stakeholder management.

The use of a marker ball in digital templating for hip arthroplasty is a well-established method of preoperative planning and is used to overcome the inherent magnification in plain film radiographs. Our hospital policy is to place a marker ball in all anteroposterior pelvic films taken in the emergency department (ED) which have been requested for suspected neck of femur fractures. We carried out a baseline measurement followed by three Plan-Do-Study-Act cycles for all pelvic films taken in ED during July 2016, November 2016, February 2017 and November 2017.

Improving the quality and speed of access to operation notes.

Introduction: Operation notes are often poorly completed, potentially compromising patient care. This project was undertaken to improve the quantity, quality and clarity of information included in operation notes, and make them easier to locate within a set of patient notes.

Methods: Operation notes were audited against standards laid out in national guidelines.

More than 40 years' follow-up of an unconstrained metal lunate replacement for the treatment of Kienböck's disease.

Kienböck's disease is characterised by avascular necrosis of the lunate bone, and over the years it has been a challenging disease to manage, with differing opinions on the best intervention. We present an interesting case of a metallic unconstrained lunate replacement that is still functioning well in a patient 40 years after surgery. This case report represents the longest follow-up of any such prosthesis.

Improving documentation in surgical operation notes.

Background: Accurate documentation in surgical operation notes is crucial in facilitating the postoperative care of surgical patients and forms an important medicolegal document. This study audited the quality and completeness of documentation in surgical operation notes at a single district general hospital against the Royal College of Surgeons (2014) Good Surgical Practice guidelines, and looked to improve clinical practice through improved compliance with these guidelines.

Method: A total of 101 operation notes were audited from a variety of surgical specialities in November 2014 (cycle 1) and 100 notes in May 2015 (cycle 2).

Anterior cruciate ligament injury: A persistently difficult diagnosis.

Background: Historically anterior cruciate ligament (ACL) injuries have been diagnosed poorly. A paper published in Injury in 1996 showed that less than 10% of patients with an ACL injury had the diagnosis made by the first physician to see them and that the average delay from first presentation to diagnosis was 21 months. The aim of our study was to investigate whether an improvement has been made over the last two decades in diagnosing ACL injuries.

Institutional Switch from Transfemoral to Transradial Vascular Access for Percutaneous Coronary Intervention was Associated with a Reduction in Bleeding Events: A Singlecenter Experience of >10,000 Consecutive Cases.

Background: Transradial (TR) access for percutaneous coronary intervention (PCI) reduces bleeding compared with transfemoral (TF) access, and may reduce mortality in specific patient subsets. However, switching from TF to TR access is associated with a learning curve and it is unclear whether benefits observed in randomized trials translate into practice. We sought to characterize the trends in bleeding and mortality rates at our institution, as we changed from being a TF to predominantly TR center over a 5-year period.