TITLE:
Audit of Fracture Clinic Services: Compliance with BOAST (British Orthopaedic Association Standards for Trauma and Orthopaedics) Guidelines
AUTHORS:
Abduljabar Hamza, Peter Obaleye, Okhifun Imobhio, Mudassar Ahmad, Kuen Chin
KEYWORDS:
BOAST Guidelines, Fracture Clinic Audit, Trauma and Orthopedics, Imaging Delays, Patient Satisfaction, Fracture Management, Virtual Fracture Clinics (VFCs), Multidisciplinary Care in Orthopedics, Frailty Pathway, Service Optimization in Fracture Clinics
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.15 No.3,
March
11,
2025
ABSTRACT: Background: The British Orthopedic Association Standards for Trauma (BOAST) provide guidelines for optimal fracture clinic management. However, compliance with these standards varies across healthcare institutions. This study evaluates the adherence of a fracture clinic to BOAST guidelines, focusing on imaging efficiency, patient satisfaction, and appointment scheduling. Methods: A prospective audit was conducted over four weeks (July 1st - 30th, 2024) at Queens Hospital Romford, reviewing 50 consecutive patients. Data were collected using structured questionnaires covering demographics, treatment timelines, imaging delays, frailty service referrals, and patient-reported satisfaction. Statistical analysis included Chi-square tests and Mann-Whitney U tests to assess associations between delays and patient satisfaction. Results: Among the 50 patients, 30% experienced imaging delays exceeding 10 days (about 1 and a half weeks), and 25% faced follow-up delays beyond BOAST recommendations. A strong negative correlation (-0.658, p was observed between imaging delay and patient satisfaction. Patients with severe fractures reported a 0% satisfaction rate, underscoring the need for specialized care prioritization. Conclusion: The audit highlights significant inefficiencies in fracture clinic operations, particularly in imaging and appointment scheduling delays, impacting patient satisfaction. Implementing fast-track imaging protocols, enhanced scheduling, and optimized multidisciplinary referrals is recommended to improve BOAST guideline compliance and patient outcomes. A re-audit is necessary to assess the impact of these interventions.