Quality Improvement Project on Trauma and Orthopaedic Junior Doctor Knowledge and Assessment/Management of Common Peri/Post-Operative Complications

ABSTRACT

Introduction: Foundation doctors knowledge of common peri/post-operative complications can be hugely variable when commencing Trauma and Orthopaedic rotations. This can result in reduced awareness and confidence in the assessment and initial management of surgical complications. A quality improvement project was therefore designed with the following objectives: 1. To assess the confidence of foundation doctors on the assessment and management of common peri and post-operative complications on starting and finishing their T&O placement;2. To offer regular orthogeriatric teaching on assessment and management of common peri and post-operative complications;3. To review and produce a booklet on assessment and management of common peri and post-operative complications and deliver to all T&O foundation doctors and possibly expand to all surgical specialties;4. To review if the above methods were successful in improving doctors' knowledge of assessment and management of common peri and post-operative complications. Methods: PDSA cycle. Anonymous survey pre and post rotation sent out to all F1 and F2 doctors. This assessed their confidence before and after their rotation in seven different common complications. We also asked for feedback regarding how they felt their confidence would be improved (formal teaching, sim sessions, producing a guide, etc.). This was repeated over the course of the year covering three sets of four month rotations. Results: The QIP illustrated that foundation doctors improved confidence in managing complications with a combination of regular formal teaching, receiving a complications handbook/guide and through informal feedback on ward rounds. The audit illustrated areas where confidence was low and did not improve (wound healing) or the guide lacked information (diabetes management and COVID). Through improvements in teaching and the guide we were able to see increasing confidence levels throughout the subsequent cycles of the QIP. Conclusion: (1) F1 and F2 doctors often have low confidence when starting a T&O rotation in dealing with common peri/post-operative complications. (2) By offering formal teaching, producing a booklet and feedback and assessing F1s and F2s regularly during their rotation we were able to see an increase in confidence. (3) Further QIP cycles should be undertaken to further pursue ways of engaging and improving junior doctor confidence.