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A retrospective audit of the timescales involved in the diagnosis and management of suspected Achilles tendon ruptures at a single NHS Trust: a quality service improvement and redesign project

A retrospective audit of the timescales involved in the diagnosis and management of suspected Achilles tendon ruptures at a single NHS Trust: a quality service improvement and redesign project
A retrospective audit of the timescales involved in the diagnosis and management of suspected Achilles tendon ruptures at a single NHS Trust: a quality service improvement and redesign project
Introduction: the Achilles tendon is the most frequently ruptured tendon. Prompt diagnosis ensures optimal management decisions are instituted early to ensure the best outcome and patient experience, at minimal cost to the United Kingdom National Health Service. Despite this, regional and national variations to diagnosis and management exist, with anecdotal evidence of inefficiencies in the local patient pathway. To explore this further a retrospective departmental audit of timescales from presentation to ultrasound diagnosis and definitive treatment decision was undertaken.

Methods: all suspected Achilles tendon ruptures in 2018 were identified through electronic and written patient records and information on timescales involved in the diagnosis and management of each compiled. Descriptive statistics were used to map each step of the pathway and timescales involved, with performance assessed against local departmental standards and the Swansea Morriston Achilles Rupture Treatment (SMART) Protocol.

Results: in total, 119 patients were identified, of which 113 received an ultrasound
examination. Local departmental standards were met in the majority of cases, with 78% (n = 88) diagnosed by ultrasound within one week of the request and 83% (n = 91) given a treatment decision within two weeks of presentation. However, this was suboptimal when compared with timeframes utilised for developing the SMART protocol, with only 7% (n = 8) scanned within 48 hours of presentation.

Conclusions: key areas of the patient pathway were identified for quality service
improvement and redesign, with multidisciplinary discussion resulting in the development of a revised patient pathway which expedites diagnosis and treatment for these injuries.
Swansea Morriston Achilles Rupture Treatment protocol, Treatment, quality service improvement and redesign, ultrasound
1742-271X
Williams, Catherine J
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Hodkinson, S
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Chandrasekaran, K
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Koc, T
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Gibb, I
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Dando, Charlotte
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Bowen, Catherine
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Oakley, J
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Williams, Catherine J
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Hodkinson, S
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Chandrasekaran, K
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Koc, T
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Gibb, I
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Dando, Charlotte
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Bowen, Catherine
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Oakley, J
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Williams, Catherine J, Hodkinson, S, Chandrasekaran, K, Koc, T, Gibb, I, Dando, Charlotte, Bowen, Catherine and Oakley, J (2021) A retrospective audit of the timescales involved in the diagnosis and management of suspected Achilles tendon ruptures at a single NHS Trust: a quality service improvement and redesign project. Ultrasound. (doi:10.1177/1742271X211023800).

Record type: Article

Abstract

Introduction: the Achilles tendon is the most frequently ruptured tendon. Prompt diagnosis ensures optimal management decisions are instituted early to ensure the best outcome and patient experience, at minimal cost to the United Kingdom National Health Service. Despite this, regional and national variations to diagnosis and management exist, with anecdotal evidence of inefficiencies in the local patient pathway. To explore this further a retrospective departmental audit of timescales from presentation to ultrasound diagnosis and definitive treatment decision was undertaken.

Methods: all suspected Achilles tendon ruptures in 2018 were identified through electronic and written patient records and information on timescales involved in the diagnosis and management of each compiled. Descriptive statistics were used to map each step of the pathway and timescales involved, with performance assessed against local departmental standards and the Swansea Morriston Achilles Rupture Treatment (SMART) Protocol.

Results: in total, 119 patients were identified, of which 113 received an ultrasound
examination. Local departmental standards were met in the majority of cases, with 78% (n = 88) diagnosed by ultrasound within one week of the request and 83% (n = 91) given a treatment decision within two weeks of presentation. However, this was suboptimal when compared with timeframes utilised for developing the SMART protocol, with only 7% (n = 8) scanned within 48 hours of presentation.

Conclusions: key areas of the patient pathway were identified for quality service
improvement and redesign, with multidisciplinary discussion resulting in the development of a revised patient pathway which expedites diagnosis and treatment for these injuries.

Text
Retrospective audit of timescales involved in diagnosis and management of suspected Achilles heel rupture - Accepted Manuscript
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More information

Accepted/In Press date: 15 May 2021
e-pub ahead of print date: 15 June 2021
Additional Information: Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Health Education Wessex and the National Institute of Health Research (Transitional/Bridging Award 2019/2020).
Keywords: Swansea Morriston Achilles Rupture Treatment protocol, Treatment, quality service improvement and redesign, ultrasound

Identifiers

Local EPrints ID: 449707
URI: http://eprints.soton.ac.uk/id/eprint/449707
ISSN: 1742-271X
PURE UUID: 5a4ea499-b9ba-4922-b803-0046019e2d88
ORCID for Catherine Bowen: ORCID iD orcid.org/0000-0002-7252-9515

Catalogue record

Date deposited: 11 Jun 2021 16:31
Last modified: 27 Aug 2021 04:01

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Contributors

Author: Catherine J Williams
Author: S Hodkinson
Author: K Chandrasekaran
Author: T Koc
Author: I Gibb
Author: Charlotte Dando
Author: Catherine Bowen ORCID iD
Author: J Oakley

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