Redesign Goals

The goals of the fracture clinic redesign process were to ensure that:

  • Simple, stable injuries that do not require specialist review are managed once, definitively by the Emergency Department
  • Injuries that required specialist review were assessed rapidly by a consultant, with a decision made about review and treatment
  • Any face-to-face review was at the appropriate time, by the correct team: there should be no wasted encounters
  • Diagnostic uncertainty should be resolved early through use of clinical protocols and imaging
  • Adequate time is available for both telephone and face-to-face consultations
  • Follow-up appointments should be at standard intervals agreed by the specialty teams, for predefined goals
  • Variation in management should be eliminated
  • Training and support of junior medical staff is enhanced

We aimed to develop a high-quality process to achieve these goals. The process is modelled on the Institute of Medicine’s aims for high-quality healthcare:

  • Safe
  • Patient-centred
  • Effective
  • Timely
  • Efficient
  • Equitable