Designing a new orthopaedic trauma meeting proforma to improve documentation in a large UK teaching hospital

In England, around two million fractures occur annually, with 250,000 requiring hospital admission. At Wythenshawe Hospital, the Trauma and Orthopaedic service discusses 10-15 new patient cases every weekday. We aimed to design and implement a structured proforma for the trauma meeting to ensure clear documentation of trauma meeting discussions and orthopaedic plans for each new patient at Wythenshawe Hospital.

Based on a literature search, input from orthopaedic surgeons and analysis of existing documentation, we created a proforma. We collected data in four phases: pre-implementation (1-10 October 2022), post-initial proforma (11-20 October 2022), post-updated proforma (20-30 October 2022) and long-term effectiveness (20-24 November 2023).

Phase 1: 90 cases reviewed; 64% had inadequate documentation. Key details were often missing. Phase 2: After proforma implementation, 98 cases reviewed; documentation increased to 94%. Significant improvements in recording consultant names (92%), imaging (59%) and diagnosis (80%). Phase 3: After feedback update, 108 cases reviewed; 88% had documentation. Improvements in documentation of imaging (85%) and weight-bearing status (57%). Phase 4: One year later, 85 cases reviewed; documentation at 84%. Key details such as consultant names and imaging reached 100% completion, diagnosis at 97%.

This study proposes a standardised trauma meeting proforma to enhance the efficiency and accuracy of trauma meeting documentation. Our findings highlight the need for professional bodies to establish guidelines for trauma meeting handovers. We encourage further research into effective trauma meetings and suggest our proforma as a template for other orthopaedic departments to adapt to their needs.