highland orthopaedic and trauma (access) optimising use of trauma and elective capacity piers...
DESCRIPTION
Clinicians: Triaging letters 1 consultant 1 session Urgents to on call surgeon ‘Only those needing surgical opinion’ Booking procedures Ortho administrator PFB Returns by need Virtual #/Arthroplasty clinics Flex IP/OP In over job plan activity (informed by DCAQ) Fill IP/OP avoid DNAsTRANSCRIPT
Highland Orthopaedic and Trauma (ACCESS)
Optimising use of Trauma and Elective capacity
Piers RenshawRaigmore
Raigmore:• 11 consultants, 8 on call• 5 trainees from Dundee and Aberdeen• 2 SD and 1 GPST • Subspecialities
• Shoulder• Foot and Ankle• Spine• Hands• Paeds• Revision
• Large geographical area with fluctuating population• Large peripheral commitment• @300 hip fractures per annum• @800 arthroplasties per annum• Consume our elective smoke in future ?
Clinicians:• Triaging letters
• 1 consultant 1 session• Urgents to on call surgeon• ‘Only those needing surgical opinion’
• Booking procedures• Ortho administrator• PFB
• Returns by need• Virtual #/Arthroplasty clinics
• Flex IP/OP• In over job plan activity (informed by DCAQ)
• Fill IP/OP avoid DNAs
Beds:• Two wards
• Trauma 30 beds• Elective 28 beds
• LOS• ERAS• Hip fracture nurse
• Minor trauma home while waits• Geography• Pre planning in periphery
• Care elsewhere • Remote non operative care• Repatriation
Theatres: • One all day trauma list (recently converted from split El/Tr)• One half day trauma list Sat and Sun• Two all day Elective lists at present (Longstanding plus Vanguard)• Planned theatre refurbishment includes two Elective theatres plus trauma
theatre• Session usage
• Monthly partners meeting• Start times/surgical briefs• Number of cases• Full day lists• Anaesthetic/surgeon issues• Scheduler !?
Other locations:• Periphery (clinics why not operating)
• Belford, Fort William• Caithness General hospital• Golspie• Broadford, Skye
• Off site but in Inverness• Advantages
• Beds protected• Teams protected• Ring fenced
• Disadvantages• Sick patients• Less flexible if increased trauma load