by Will Mason

Poster Download

Background:

Acute orthopaedic referrals have greatly increased, stretching our resources. Patients either wait to be seen in the Emergency department or are admitted while awaiting test results though discharge can then take longer than expected. Some patients require admission solely to receive intravenous antibiotics.

Method

We performed a two-week feasibility trial of a Trauma Assessment and Treatment Unit (TATU) with two main aims:

1) prevent avoidable admissions

2) reduce waiting time in ED

For two weeks in June, we converted one six-bedded bay on ward 3B to an assessment unit, with reclining chairs. It was staffed by one nurse and the on call orthopaedic team (Consultant, Registrar, F2). We also trialled using once daily intravenous antibiotics, to allow day case treatment when appropriate.

Results

Over 14 days, we admitted 83 patients, 21 of whom returned for further planned assessment or treatment as a day case. Of the 84 bed days that were lost by converting the bay, 54 bed days were saved by patients avoiding admission.

The presenting complaints were as follows: 49% infection, 17% fractures, and 19% acute spine conditions. Patients spent a mean of 3 hours on TATU. The number of patients seen each day varied between 5 and 17.

95% of patients were extremely likely or likely to recommend TATU to a friend or family.

Next Steps

There were some concerns over privacy, which will be addressed.

These results show that TATU in this site is viable and merits further development. We plan a longer trial to better evaluate its effect.