Inpatient consultations to an orthopaedic service: the hidden workload

While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

To prospectively audit the pattern of inpatient consultations to an orthopaedic service.

Data were prospectively collected on all inpatients referred to the orthopaedic service over a 4-month period.

Sixty-eight consultations were received in the study period. The average age was 68 years (range 20-86 years). Seventy-two percent of consultations were from medical services, 25% from other surgical specialties and the remainder (3%) from the psychiatric department. Eight (12%) patients required surgical intervention. Twenty patients (29%) had previously been seen in the outpatient department.

Inpatient orthopaedic consultations generate a significant workload and the majority of such patients could be seen as outpatients. Clear and explicit guidelines on appropriate referral pathways, as well as enhanced education in the management of musculoskeletal disorders and available services may optimise delivery of patient care in the inpatient setting.